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STATE OF CALIFORNIA <br />DEPARTMENT OF INDUSTRIAL RELATIONS <br />DIVISION OF OCCUPATIONAL SAFETY AND PWLTH <br />PERMIT <br />Permit Issued To <br />(insert Employer's Name, Address and Telephone No.) <br />SJ Weaver Contracting Inc dba SJ <br />Weaver & Associates <br />2651 Walnut Ave <br />Signal Hill CA 90755-1830 <br />(562) 290-8859 <br />Type of Permit T1-ANNUAL.TRENCH/EXCAVATION. <br />M <br />Date 12/5/2003 <br />Region 3 <br />District 1 <br />Tel. (714) 939-0145 <br />Pursuant to Labor Code Sections 6500 and 6502, this Permit is issued to the above-named employer for the projects described below. <br />State Contractor's License Number 71 71 73 Permit Valid through December 31, 2004 <br />Antici ated Dates <br />Description of Project Location Address City and County Startin Completion <br />Various Statewide <br />1/1/2004 12/31 /2004 <br />or issue date <br />whichever is <br />later.. <br />This Permit is issued upon the following:conditions: <br />1. That the work is performed by the .same employer. If this is an annual permit the appropriate District Office shall <br />be notified, in writing, of dates and location of job site prior to commencement. <br />2. The employer will comply with all occupational safety and health standards or orders applicable to the above <br />projects, and any other lawful orders of the Division. <br />3. That if any unforeseen condition causes deviation from the plans or statements contained in the Permit Application <br />Form the employer will notify the Division immediately. <br />4. Any variation from the specification and assertions of the Permit Application Form or violation of safety orders may <br />be cause to revoke the permit. <br />5. This permit shall be posted at or near each place of employment as provided in 8 CCR 341.4 <br />Received From Received By Investigated by <br />Jeff Thomas Permit Unit <br />❑ Cash Amount Date Approved by <br />® Check 40685 $100.00 12/5/03 <br />SA! ine Date <br />2/19/2004 <br />District Manager/Permit Unit Date <br />