SR0074338 - Laserfiche WebLink

Home Browse Search

.r, Jou ADDRESS: PERMIT I: LICENSED CONTRACTORS DECLARATION I hereby ancon met I On licensed under Ina previsions of Chapter 0(commenting wlm Section 7000)of Division 3 of the Suarrese and Pmlessions Code and my license is in full form one effect. License 0 948591 /J/ Expiration Dale 17,1/2ole Data 2/17/7016 Contractor—�/f��11 OWNER-BUILDER DECLARATION I hereby eaom that am exempt Irom The Cwlkactoes License Law Iw the ldlowing lenwn(Section 7D31S.Business and Profession, Code: Any city Or county which requires a Dermd to construct,agar,Improve,demolish.Or repair any structure.prxY to its Issuance. also requwas the appl"M for nal,Permit fo No a signed statement that he is boonsod pursuant to MR provisions of the Contractors License Low(Chapter 9(commencing with Section 1000)of Division 3 of IN Business and Professions Coda)or that he Is exempt norelmm and the Mals for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pemnB Subjects the applicant to a civil Penalty of rot more then We hundred voltam(S500)): O I,as owner of the property,or my employees with wages as thew Rule mmporaation,vnh du me work.DM the Structure n net Intended or offered Iw Role(Section 7044,Business and Perfessiuns Coda:The contractor's License Low does not apply to an Mover of property who builds or Improves monsoon.and who does such work himself or thrown his awn employees.provided mat such improvements we Ni mlendm or offered for Sale. If, however.the building Or Improvement is said wkmin one year of completion,the owner4luilder will have the burden of proing mal he did not bulla o Improve foe the purpose of solo.) xULx.I.as owner of the property,am MrClusFvely contracting with Icemed contractors to constnKt Ute fancied ISection 7044.Business and Professors Code(BEPC).. The Contractor's License Law does not apply ID an owner of preachy who Mill s or reproves hereon, and who constructs for such projects with a mnlradwls)k ensea pursuant to the Contractors License Law.) 0 l am merepl In do,Section BSPC for meseason_ Date: 2717/2016 Owner: WORKERS'COMPENSATION DECLARATION I hereby slftml that I have a certificate of consem to sellAnsum or a certificate of Workers'Compensation Insurance,Or a corlfied copy thereof(Section 3800.Labor Code). Expiration Date 1/1/2017 Company Travelers O Certified ropy is hereby furnished 0 Certified copy is filed with the Environmental Health Deparlment CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE (This Section need not be comPleled If the perm0 is for one hundred dollars(57001 w Ion I certify that In the perfomsence,of the work for which this permit Is Issued.I shall not employ any porson in any manner so as to become subject to the Walkers'Compensation laws of California. Date: Applicant NOTICE TO APPLICANT:IL aha making INS Certificate Of Exomphon,you should beewne subject b the Workers Compensation provisions of the Labor Code.you must forthwith comply well such provisions or rob permit shall be deame0 revoked. CONSTRUCTION LENDING AGENCY I hereby affirm het there is a censtrucion lending agency for the performance of the work for which this permit is issued (Section 3097,Civil Code), Lender's Name Lender Address DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION I hereby cengy IMI no activation We 15)or more feel in depth into which a person Is required to descend.wM be Mae in connection with work authorized by Me Pi amu that nD building slnadule.Scaffolding.faker"",or demolition lir dismantling thereof,will all more Pen thulyau(36)feel filth.(Chapter 3.2,Group 2.Anode 2,Section 341,Title B.California AdmnlSboeve Code), O AS owner-bulder,I wul ml employ anyone tom work which would require a permit from the Division of IrMusion Safety,as noted above,unless such person has a parent to m such work From the division. O Division of Industrial Solely Permit N canny Ilial I have roes this application and Nate Mal the above Information Is Cored.I agree to comply with lig Lily ON county wdnonme ter upon Iowa relating towoe property and Inspection sewage oywheres mmsimdbn,arW hcrcby aulmrim m of cols countytosoler upon the rWeimlowell waporrylarndorsepurposes. Date 2/17/2016 Applicant c 1304341 ucEnsco ca+lawcrws aauunrw +wwr