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06/19/2000 03:30 925-4F'-2559 <br />Jun 1d U1 ❑4:13P Jones <br />66/1812000 93:23 925-463-2559 <br />rjw 141!0191 ltl:l:i Cby4bajp j,i <br />ATC,PLFASANTON <br />ATC PLEASANTON <br />FIFTH FLIM <br />3451 <br />PAGE 03 <br />P.3 <br />PAGE 0a <br />PAGE 83 <br />UP Jeg4WflCc�uW t rwkratuentd Maikh Swvk*s, Ljnit N Wets ApyrUasBse Suppt»f�j <br />JOB ADDRESS. 3533�!f�m�P,�-fir KRMrr z�SG i <br />� I " <br />LICENSED CONTRACTORS DECLARATIONL( C -Q <br />hweby affirm that I am Housed uncter the proviskm of Chapter 9 (comr++org:%V 400 Seetlon 7000) of Qtvaion <br />3 of the BwltW".and`7ProfessWW Caft and my borne Ls in foil from* and «ft& <br />Lkense U: -L Ri '-� a l3 Exp" lon I aha "C 7— <br />Date: -(n i ) ` cont..'. <br />Prkrnted warns- i)!aVI cl N SVA <br />I "Obr affirm" unwr perWty of Per4ury ane of the ic>«ow daclare WM- (CWXK ALL TWAT AaPL,13 <br />1 tsitw and vwW malntsin s o&*$ AL9 of cw wnt 10 wit- nsure f*r w0rk4' 00"XW685M 41; provxW for by <br />340on 3700 of the i.ebar Code„ for th$ P&IMMMMM of ttw work for Whkh &3 p tfnk fgissued. <br />I have :acrd wA matnWn awkWe wnpwdabw Irwfllett?rl, as Mgtlired by 9oMn 3700 of dw Labor Cada, <br />for th* pOrkwnanoe Of"wore far~ this perrMt b kwad Idy wWWV compertaa4M k-4ur*nce <br />carrier wrrd pdicy n wtrhers are: <br />I eprtitY drat In th* Pe+farr"ondb Of ttts Werk for ankh this pWr"It Is issued, I shalt not wnpby any psnon M <br />any nUnner W s$ to become Subject to the workers' cornparmnuon W" of C SI*M a„ !Fld o9f+s #Wet if I <br />should bowm "Joa to the workers' cnmpaaum pMW6j rrrs of 9oaim 3700 of the Labor Code. I "I <br />foftvAth complywbb ttsoee provisam. <br />Dow - a 1 <br />printed kam.: V -F <br />WAf JMM- FA JM TO aECURE WD1tNZ" Goj4pgf4ATMW GOYbenoS 18 UMLAVAWL, AW SHALL wjwcGT <br />AN RYIKQYM70 CMMIMAL trEMALM AND W& RMU tip To ONE MUkVM THOUSAND DOLLARS <br />PROV100 11iED FOR W WXTIONN ?70/ OF THR L AWK CODE WMMW. A FEE3j AND X488 AA <br />I. _. Day, l C� ('_ _(slQntasa+e offrsy Wonsed audwra*d repmenuuw <br />hereby autlsor)sa (print nuw$ <br />10 clan Of San damp" Cawley VMI Pemt App"~ oo my trshrf. I rwlaer�rtasrd >h aufiorization Ec yilW fbt• <br />aft (1) year AAd to lit *vd to the oak purl aorta an me vW paW orvdM ePP*=M M <br />