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t JH oRE55: PERMIT#. .3`R, _ yVt- ----f 51 LICENSED CONTRACTORS DECLARATION 1 hereby Allri n that 1 am licensed under the prorlsims d Chapter 9(commencing wlh Section 7000)of 0f%ision 3 of the Business and Protessions Code and my license-is in hAl force and effect License# !2" !2 L� Expiration Date 10/31/14 Date '7^ T—Zt4- Contractor OWNER-8UILi?ER DECLARA710N I hereby affirm that I am exempt from the Conlractofs License Law for the following reason(Section 70:1-5.5,Bre netts andior to its afslssjoris ratrce. Coda. Any city a county which requires a permit to mn mlemenl f.,,nprove.ditmorish.or repair any That he is licensed pursuan!i0 4x;pmvisibnstof the Contractor's I"regWrry thio applicant for such Perrot to Us a signed Deme law(Chapter 9(commencing wkh Section 7000)of Division 3 d the Business and Protassions Code)or that tier is exempt heraimm and the basis for the alleged exemption. Any vWatron o1 Sec6nn 7031-5 by any appticard lot a permit subjects the appliraet to a civil penalty of not more than live hundred dollar($500)}- D 1,as ormer of the property.or MY employees vrlh Wages as their sole compensation.%vin do the work and the structures 13 not an intended or offered for sale(Section 7044,Business and professions Code The conhactvrs license Lace does not apply that owner of property who builds or improves thereon,and wito does such werk himself or tMouor Improvement ren is sold yees,rpro clear of such improvements are not Intended or ufi r ern for sale. Idem he did o build oer.the dri mprove for rho purpose of sefo-) completion,the ovrner buldef wall have the bunion of proving Business and 13 I,as owner of the Pfopedy,ere etar)uaively contrudko>�f(celmed mnffaclim to constn ct dha proteperty ct(Sbuilds ection ro Proresstons Code(BSPC): The Conliactofs lk erne Law dares not apply 4o an owner of pmLlce and%%4M constructs for sudt prolecis cloth 2. nhador(s)licensed pursnraM to the Contras ar's t3ceose LOW.) t3I am exwo under Section 6&pC for ih(s(easm Data: owner WORKERWCOMPEUSATIONDECLARAMON I hereby atf i m Mat]have a CaMCK:ate of cotlaent to S WP.iMre ora oerocateof WorMW Compensation Insurance,Ora CeMW copy thereof{Section 3800.Labor C.odel lawrar"Date 12/15/ -4 C "y Zurich A,,,P,rr•an Tn4 1r n[•e C'o M Cerf&Od CM is thereby flmitsried El C•effiW copy is Cued wilt the Erfyjrort171ental Hea101 Deifai'titf A CE917FICATE OF p(WnOK MOM WURICERW coup 1SAmoN INSURANCE is section need not W uom leled if itle permit is ibr one i r&ed �r IS100)RE i shat►not IgLsl emPtoY any Person in any manlier so I cetdflf that in the performance of U18 work for wtidt tomia. as to be=M subject to the Workers'C °R La—of Appgcarrt ho the Workers Compensation wren, To i.QP>_rcwms-rr.are��matrhw chis rre»7 �.a. you �m ebsammea th pnavfsions tie Labor Cada.you most fbar m c Vq CONSTRUCUON LETMING AGENCY i Hereby alliin Diad there is a r:onshudfon ten>i•Ing a9eNioJ forge performance of the work for VHch this peftrtit is issued (Sec im 3097,Ciel Code)- Lendef's Mantle Lendee Add— D1V(St1Oid OF iNDI)31i21Ai- 3AF1E'iY PERM Y CERT19CAT1017 _ or man feet in depth into ntvrh a peen Is required to descend.of l be made dei in 13 1 hereby Garb-ty 11.at ne e�ccavalion fivo(� �mat no b.?dinn strudure,scaltolding,talse'vork.of derrwiifion A ninPI 9 amaeoson with work autlhoi¢ed �Q t1efRQt 3.2 Group 2,Artiste 2.Section 341.T+Be 0,Ca7lfomia Admiritsbative thereof,wall ba more than N nlY ser(3�fit high.jrCttapte Code), nyone to do orotic which would rt<in a permit from the Division of Industrial Safety,as noted _ ©As owneraruider.I"a not employ a above,unless sorb person has a permit to 00 such work from the div; 13 Djosion of industrial Safety Permit above an ci(y and counly lien is Mourn.!aghe to auffrodze representatives o1 tins 1 crxf�y that 1 have road this appliratwn and slate that the above it4'enrha ��.and hereby ordinances and state laws relattn9 to wall construction a"d or sewagesy°em colony to enter upon the above-mengoned properly for in P h1 _ Applicant (}3(8 UCENSH7 rn4MAC CIR DGMARA7lC44 EFW 43-07 frim �.----------}—"_.