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Joe A111)1t1'. .see PLw PeRalrrr
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<br /> LICENSED CONTRACTORS DECLARATION
<br /> herefly aatrm toys I am Irparyad.cwt nr the prortsxx,s d Chaolu 9(rrxrmer,rwnq war.SerAOn fowl d Dnlaon 3 dtNa 0ttlM1s and
<br /> P-oesesons t.aSe a,4 my aCrnaw.x.o?,,lo It—*and soba
<br /> lions.r 954267
<br /> Expiration Date 7/31P2020
<br /> Da111 _._ Contractor GOO-Ex
<br /> ' OWNER-OUILDER DECLARATION
<br /> !A*WW aft VUII I em eaempt tram tles Ccx11aeiora Leans.I.aw kx the froowinp mason ISectax+7(M 5.&Ames.%anA Prdas.ia+tn
<br /> Coda Any dy or counly rturh requasra a m,,rut to Ca 311'L 1,aaur tmprrnre,dwttressh.or rnra-+any saiuctum,Pani 10 do iaa,A
<br /> alga rsllpdras 115.ppkpnl$ar such parn"l to file a sVowd 5tste+rord that he is 4(wnaed Dr Suanl to he provisions of spin CoonsVy n I
<br /> Lowest Law(Chapter 9 joamltwncrg wlr,% Scw:lon MW)Of D'Mlc^3 all the 9u,,vwss anti Prtsemnxrs Cnida)or that Mr i s osomPl I
<br /> hstaftili and this baps b"the bunged exe,,iplirn Ary rwr8ru,d Becton/U31 5 b!r any aPPl r'anl kr 4,e`ma wrt;w oro anr).wan1
<br /> To a rvw persally sf!not nary Irsn love hurnbo+f dallarn(s5mll
<br /> D',as rAvnw ni to pmporty,o my rantroyrrea wish wages lir,area sola Compsrreatpi,as du the ODIN,anti the slhidure a ncA
<br /> eKerrdeoi ornl(wed top ea4!£,•cOrx,70",Buainaaa yup Rdwarrxit Coda[ The earfnob's I-conse I one flim rot appy to an
<br /> Dvmm d PYK+e`fy wi o bll.ids no,irnl`n>Ms Iharaon,and who does Such work flalaea or rawClt his own;ernpsoyees,Orovndes2 that
<br /> arch irnpraverneras ah not �raen6nd or offered or sale M, Waterer,Tho tlutdny o arprarenera a WId wl Nn one ear at
<br /> romp ahnn M owns tastlder-il.—rw rw✓»rn of Wvvw.g Itnat he iW not bald or ratprort ILr Itw purpose d sale.) y
<br /> O t.as ow,xir ofoil;wo& am exr.�sevey mntr
<br /> P okrsarxy Gods
<br /> wfh laeneso axstagore to cOlON kl t"e PnIled(Sector 7044 ©:.army.arri
<br /> e(TIdM)PC) I',-Gonrecturs I c-noo Law mss not apply,to an ayeker 01 i,mP fly aft builds or nvrrsvdw!araton,
<br /> and who CORSanN}r kx arx�•`lvr}"s we:,a mntaryun s 1 Ir sed wnuara to the Combw jws l wAn"Laa,.)
<br /> D am naernq s r7rs Sreio` B&M for tna rwason
<br /> Deft: Owner -
<br /> WORKM'COMPENSATION DECLARATION
<br /> I Mmby afrem that 1 have a codus ate of consent 10 1wa irw<.ni at a aertfirabr d Wty anon C,ilrpa,s y6an,
<br /> Ih �t.auranco.It(s caroted rux,y
<br /> erwsl jSecbao 3WO,Labor Code)
<br /> Exp+rallon Daft—1112.4 1710 Comparvy ��YS�S�aL�1 {��jL4., C�]• _
<br /> O^en l.rc mpy A hereby rumsu red I
<br /> C.ort tial ciao.s tired so the Ertvnonnrsenfad HwNh Deparbnonl
<br /> CERTIACATE OF EXEMPTION FROM WppW:Ftg•COMPENSATION INSURANCE
<br /> T7i x cortrrr rWsr rh t>s 2XU,. tnl d the Det ml s bf gov r�rstlrad doarkea R1M1 .n
<br /> irony 11at m Ow Derform nonio M 9 w wulh la wh ot,if se iierm,�A M*,ed.1 snarl!nal a
<br /> brrrrxne w $alta Workers c.e er^Pks1' ny[parson rn arty rrnani,er su u Itis
<br /> b/tr! DwILdd_1 I aws d Callhsnna
<br /> Debt. _ Appticam
<br /> NOTICE t10 APPLICANT a,artr making t.R L:erehcahr of Exemption you shotdd briname,ft tiler,to Wo Works",Carnpsnsaban
<br /> Orosimm*d the Latxr Code.yarn moat f ymwdh con uy w.lh s,x:1,pnswnana a I_pa.rn,lines be eaaned raroloo
<br /> CONSTRUCTION LENDING AGENCY
<br /> 1 herelsy army Mod lirorn ns d ermsiruCbon w-di g agency Mn s,a vertormartra d the wok kv whish Iva perm,.a,aaun]IS,rrksin 3097,
<br /> Civil Cate).
<br /> Lender's Name
<br /> LarpoWs Addras
<br /> DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION
<br /> 1 ttatsby cartty that no 4acayatton hyo(5)IN rrsoe lief in lopes irtb which a pew.,is regssrled 1'i descend ws be made in
<br /> 010900110n wit^Wourk WAWUad by the perni and that no b%"ng studurt,WA*Oldlog,lahaeagrt<,ur densCi4,0n or bsn>antlnttg
<br /> Codisi W 71 to mcxa than tlMtrd+i (36)fief high (C�rapyr 3 2 aro o:.Ar"!s?.Swo 341 True n.r aen Iia Adm.rs
<br /> fst,nnn
<br /> Creel
<br /> O AS OW'lar-buWW,1 so r"smo"WrAWW in do work which wmsld naJaim a Parnas tnfm aw D"",of irrrk,ab,a Sateny _.ciao,
<br /> above,unless s w h pen kon lug a porrrld In do such work horn the dwv n
<br /> O Dihswn of woustrret Safety Pwml•
<br /> I rro"that I h.TA Iwai this aPotaaloin and eealo hurl the*be"rrdamsf4mn rs c rted I ayrurr to ctm•t,y with all city 2"cmrty
<br /> ardesonCaegran awro re14116rsg to was construction and o sewage syalem Crxutur1 m,aro hiio autho va rpprrrjsenbbvn.M this
<br /> cos"ty to aaty upon tie abOM mwlror>sd pr Xwty Tor inspertsm purposes
<br /> Date 300 Applicayll Mdrim Maaoy
<br /> twasel4m
<br /> ars a Liana a exirnxac resss oeca,v+ayaar
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