|
SPECIFIED DECLARATIONS
<br />LICENSED CONTRACTORS DECLARATION
<br />I hereby antra that I mm licansod under thei proylolors of Chapter 9 (commencing with Section 7000)
<br />at Ceram 3 at the Mosfross and Prolosolons Coda, and my MOWN, II In Nil force and edict
<br />Mime 0 ke.30,5 Upholder Dal* ip.00 0
<br />Dora / a 4 - Contractor ,FL,St_i-f e-171/i
<br />OWNER BUILDER DECLARATION
<br />1 hereby edam that I um sump *art rho ConlmOtor's llunsit Law tor the following fOO*091 (Sec.
<br />7031 5, ileaktess and Prolosakins Cod*: Any sky or county which Tequilas • pormit to construct, alter,
<br />Improve, dernollsh, or repair any airucturo, prior to be lostonoo, •Mo ',quires appikont for such
<br />ppm* to Mit o signed stabomenlIbm he is humid pursuant to dui provisions of %ha Conhactol'o
<br />Lions* Low (Ch•pitir $ loonowancIng with Section 7000)01 Diuksloo( 301 this Stisinims and
<br />Profiloo10110 Code) or Mai itir is 'RUM Vorokont end Oa buie for do allogod siernittlon. Any
<br />titorodon of Section 7031.11 by any *rollout for a permit wrbloolo the oppikant to a civil ponalty of not
<br />more than Moo huouirted *tilers ($500.00).):
<br />so WIWI of ths property or my omployeiss veer wog,* as thok soft compensation, will do the
<br />work, and the struclut, is not branded or offered for sale. (1144. 7044, Dusinoes end
<br />Profssolosto Cods: The Cantroolor's Wows* Law duo not apply to an owner of properly who
<br />Waal or Impfolfila thirteen. end who dose such wait hinwrIf or Ihrotigh his own employs's,
<br />provided that such Improvements are nor intended or offered for SOM. N, however, the
<br />btolirilni Or improvonont to sold within ono year of completion, the ownwOulidor mM haVa the
<br />burden Of proving that he did not build or Morava for the purpose of sale.)
<br />0I, so memer of the property, am archisivoly outroroUng with lioanead confroaloro to construct the
<br />profrict. (Soc. 7044, Etrolitoss end Profssalons Cods: The Contractor's Liconso Law does not
<br />apply to an *MY of property who build, Of Improves Magoon, and who contracts for such
<br />profsob with • untraeleoloontractor(s) license unwept to the Contractor's limos Law.)
<br />UI arn *ramps undo, Soc. , of Ole Business and Profession. Cods for trio
<br />following reason:
<br />Date Owner
<br />WORKERS' COMPENSATION DECLARATION
<br />I bomby ofEnn under portal of perjury one of the folistrIng decartations: n hays and MN notrMsin a contflosto of consent to solf-frenno for workers' compensation, as
<br />provided for by Seeder 3700 of Ms Labor Coda, for Um porta/nonce of Mo work for which this
<br />permit Is Issued Er I have end will mitolalit wading compensation Insvforeco, as required by Sutton 3700 of the
<br />Labor Cods, for Vie porformsmo ol me work for which this permit is Issued. My workers'
<br />wraps, canter slid policy number WM
<br />Cantor 54rr Policy Number 1 531o.POS
<br />frolit sulker rood net its colsPieled If the porton Is Or ortel hundred dollars ($100) or laws,
<br />I NAN, that In rho porfOrmoros of the work for Which IMO permit Is 19,0,d, I shall itof employ
<br />any person In Ony fftelliWt GO SO to become sublut to Via workers' componastIon laws of
<br />olutcsitla, sag woo that R I should become sublriot to Ma workers' comminution provision, of
<br />Section 3700 of Ms tabor Cod', I shall forthwith comply MO those provisions.
<br />Dote 0-7,3 .7no APPiiconl
<br />WARNING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
<br />SHALL SUILJECT AN amPuivam TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ME HUNDRED
<br />THOUSAND DOLLARS (11100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
<br />PROVIDED FOR IN SECTION 3704 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
<br />CONSTRUCTION LENDING ADENCY
<br />I hereby affirm that thou M a ormstruellon loading comity for his performance of Ito work for which
<br />ISO permit to lostrod pies. $007, MO Coda).
<br />Landor's NM, LAU*
<br />Crryilitere
<br />
<br />Phone
<br />DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION
<br />0
<br />
<br /> I hereby certify that no utavalion fIvo (5) or mom foot in depth Mlo which s porton Is required
<br />to dosoond, anti be 'node hi connection nith work authosizod by ads permit, end that no
<br />bulkOng, strucurrik soifkiding, foloonrork, or demolition or Reminding **roof, MO be more
<br />non intwywit pen toes high. (Chap. 32, Dip. 2, AA 2, Sec. $41, Ittla 0, CAC.)
<br />As swerboundor, I MN DOI employ rumors to do tuck UM* would ',nuke a permit from the
<br />nallastoof giousugoi woo, as naiad above, unIOSO such person has a permit to do such work
<br />from** DIvioiom
<br />LI Olvition of Industrial Safety Ninon N.
<br />I unify Mir I hero rood atia application and Mom Mot tho above Informodon Is correct. I ewes to
<br />comp,/ with MI ally and cesiory indiums' said Mato bus Malinig to trading constriction, end
<br />hereby 4st/dodo reiroosastethos of this town to silty upon the entweinendorted property lor
<br />Moped= poporros.
<br />Dem Applioanl
<br />EXPIRATION
<br />INFORMATION
<br />Every permit Mewed by Mr Building
<br />Official undo', it. provisions of Vile
<br />Cods shall expire by limitation and
<br />become hell end void if IA* Building
<br />or work authorized by such permit
<br />Is nor commencod within 150 flay,
<br />horn the dote of ouch permit, or If
<br />Vi. kolidInco or work avIhisrlsed by
<br />such WW1 I. ousponded or
<br />obendened or any Onto aftw, fro
<br />wort Is commenced for e period of
<br />190 days. Work shall Ito
<br />conelderod abandoned If an
<br />Inspection haa not boon approved
<br />and recorded wIthin ISO days,
<br />INSPECTION
<br />INFORMATION
<br />The San Joaquin Courtly Building
<br />Inspection Dtvlstort has Inotallod en
<br />automatic recording device to
<br />fuel,' *omicron request,. This
<br />service will he evellable 24 hours a
<br />day, lover day* a worth. Calls will
<br />be %ion off rho recorder st 3:00
<br />p.m. every workday and distributed
<br />for Inspection the following
<br />workday.
<br />To request an Inspection, plume
<br />Cell (209) 449-31115. You will be
<br />requested to provide Me tot/owing
<br />Inform/Mon:
<br />Permit Number (ldandolory)
<br />Your NMI%
<br />3, Job Sits Addrssii end Nearest
<br />cease Surer
<br />4. Tun:mono Number
<br />15. Day Inajtattion Prararrod
<br />S. Typo of Inspection
<br />PG&E
<br />INFORMATION
<br />PG&E has asked Mai we notify ill
<br />persons who will need new per or
<br />electric service to 00filUti them as
<br />to proper location of both moors.
<br />If your building project Involved
<br />utilities supplied by POLE. Pies.*
<br />contact them at (109) 465-49st.
<br />AP • reminds/. PG&E and the
<br />telephone **moonlit* also
<br />recommend you maks
<br />orrangemour with them es *arty ae
<br />possible 10 Wain** delays in Pm
<br />connutton of your rervico.
<br />Dec 14 00 08:23a
<br /> Chris Fisch (209)772 -3571
<br />
<br />P.3
<br />Geo11. ...CONOOF EAVH TECHNOLOGIES
<br />
<br />N7.) 342F P
<br />00022)0
|