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` �`� CITY OF STOCKTON
<br /> `7� COMMUNITY DEVELOPMENT DEPARTMENT
<br /> ;I, BUILDING DIVISION, CITY HALL PHONE: (209) 937-8561
<br /> �i� STOCKTON, CALIFORNIA 95202 24 Hr. Inspection Request
<br /> PERMIT ApplitaticA 60
<br /> t, Nuberueber
<br /> LICENSED CONTRACTORS DECLARATION CA 00005316
<br /> 1 hereby al0mt that l em licensed under promsdns of Chapter 9(commencing
<br /> with Section 7000)M Division 3 of the Business and Professions Cade,and my
<br /> license S in full 101ce ntl�elye.G. Ii$ge Gate
<br /> CONTRAD-OH—
<br /> �7 ] C��''II ' sA. ANENTa kG 8111;C9
<br /> LICENSE NO. (aL
<br /> LICENSE TYPE f e a £S " DATE $//-O T f• -e 'J
<br /> rtl+)1. Type OUTSIDE COANECTI0N----"-----2L
<br /> STOCKTON BUS.LIC.NO. Subdivision
<br /> ,
<br /> OWNER-SUILDER DECLARATION Parcel Hbr CIC iS0 21
<br /> 1 hereby aYum Trot,am exempt from the contractor's License Law for the
<br /> folwwirp,fawn{Sa<J031.5 Businaw and Profession.Code:Any city or county 6eC Lode , 1208 0; 02 15
<br /> whits %fres a permit to coneth;cL alter.improve,demdI of repair any souclure
<br /> prior too its,ssuarke.also requires the appMAm for such permit to filf,a Signed O finer Name , r SCHKIGT AlBERT I L Tad
<br /> 5letenoni That he if ficensad pursuant to the provisions of the CamracMr's Liconow
<br /> Law(Chapter g rammenurtl Section 7000)of Division 3 of Me Business and AddrCSS , , ;,020 NOUAAN RG NE
<br /> Professions C.A. or that he is exempt therefrom and the basis for the alleged
<br /> exemplbn Anyvialalionol Switch 7031 S byany applirantbre oermasublectathe niNVSTUN dA 9C3h6
<br /> applicant to a civil penalty d not more that live hunched dollars(5500.): Appl Type . OUTSIGI LUNtJCLT - SE'dER
<br /> ovm ❑ I.asownere;Meproperly,ormyemplcyeasmthwagesastheir sure GEsi g{ Work , kE6:GENTIAL
<br /> pentalion,will do fie work,and the structure d not Intended o:offered kr,sale
<br /> (Sec.7009).Business And Profeasiww Cotle:The Cxtractofs I.IL9nae Law does SEWER LIKE
<br /> apply to an Owmar of Oropedy who builds or Imves prothereon,and w.ho does
<br /> such work himself or thrown his awn employees,proyioea that suds improvements
<br /> ere nornerded or otletad Iw sale.If,however,the building or intyrovemenl is Sold
<br /> within
<br /> ons, of cumplation,If,ofraw-buolOw will have the du an of provingfha( 54Uare ftf , G ZUfIIng , , . , 000
<br /> he de not build Q�improve fon Mw purpose or of sale.) q
<br /> ❑ I,as owner of the Property am exclyswo: contracti UCCifp arOdp , . LUn$E Type
<br /> y ng with licensed
<br /> wnin^las to construct Me omect fsec.iPw.Business and Proessian6 Cotler
<br /> The Conosu!orsU eance Law tlaea not appy la any owner of property wMo bulkle or
<br /> Improves thereon.and yfio contracts for Such proI with a contactor(s)Ilonfuld Special kOtc$ rind Ll_a J i ti 0 r,-a
<br /> MI-14Ma the 00,11ccJx's License Lew.) AN ENCRUCHNENT PIRNIT ISS RQUIR[b pklOk
<br /> ❑ tam exempt under Sec. 5 8 P.C.lot MIsIc'•'
<br /> TO COtt,(.LTTUN TO a CITY NAINTAif7EG
<br /> reason
<br /> UTIETT'i
<br /> Data Owner THIS TS A PERNIT FOR IHI COLLE TION OF
<br /> SEWER CONNECTION PEES ONL4. A 6UILFiIWu
<br /> PERMIT NUsT BE O6TAINEG FROM THE COUNTY
<br /> OE SAN JOAQUTNI PRLDk Tb THE
<br /> NOTE: To protest the imposition of any development fee, dedication,
<br /> reservation or other exaction imposed en your project,you must Nle wdben .pkM[NCIN[N7 Uh WIIlk
<br /> notice with the City Clerk's office within 5o days Sher approval of the project
<br /> cryfmptal of the fees,tledi ,catlart reservations or other exactions stating
<br /> that the required payment is tendered or will to tendered whey.doe,or that
<br /> +Sty canddlons which have town imposed are provided for or salisfied,under - - - - - (IES - - - - - - - - • - - -
<br /> protest,alo7,with a statement of the actual elements of the dispute and the ^ T1,
<br /> legal theory(turning the basis for Me protest Ii' GN ad FEE
<br /> WORKER'S COMPENSATION DECLARATION rY!'-AJ6-,ATGN IN FEE $a9F I12EJ.gI
<br /> I nereoy anirm that l have a cadihoate a u)nsenno self-maure.of a cenihcad, '''0-A0D-iS-u F;EEil6k IAk $al JI Sat.i2
<br /> N Workers'ComPensanonlnsurance,oracerifiedcopy thereof(Sec.3Bo%Lab.c.) F'W-AO6-96-CFD 3U-A $SB 1139S.CS
<br /> POIi No.
<br /> Company F'W AO6 SC ATHEkTON $Cb CS'+,SS
<br /> �❑'1 Caninad ropy M rareby furnished Excess If"WW-CON6-k'SG/A FAJ 2&11`12.00
<br /> 'J Corti)ad copy K filed with Joe oily pviI&9 nepectron tlepanm m,
<br /> Dae ,Applicant _ ----------
<br /> CERTIFICATEOFE)(EMPTIONFROM WORKERSCOMPENSATION INSURANCE PERMIT TUTAL IC160G,II
<br /> This soder head nM be c pfeed d the pamut la for one hundred doCao
<br /> (gfC0)orle66.
<br /> I cantly Mat in the padMmanrx of the work for Milo this parrot is issuetl.I /
<br /> "it not am bn Wy 8ny pension:n y m£MdI 50 a8 to become BYbjeel.,If
<br /> CamoensetwS Of California.an
<br /> 081e _Applicant -
<br /> NOTICE TO APPLICANT II,attar making Inis Caruficate of Examplaw YOU should
<br /> become sublac w Ta Workers'Compensation provisions of Ine Labor Code,you
<br /> must hvlhwilh comply rich such providon6 or Ings omni shell be deemed revoked.
<br /> I Ledlh•,nal I have read niie applicaw,and stale Yial,he above information
<br /> correct
<br /> agree to cdmply wiln all coy and county✓tlnerrces and
<br /> stale IaWs
<br /> teidting a uiltling 61ruCEtn.a:d hereby aMlSodea repreeonlativa9 MMia dty to
<br /> soler e A Mldnetl p operry r ion 4Lmos
<br /> S:IaNE (f O (S L u
<br /> rAlDfi£SS 1/'LjJ•rj t C�
<br /> !OB AID E S_ _l
<br /> APPLICATION APPROVAL
<br /> uERMIT DOES NOT BECOME VALID UNTIL SIG ED BY THE BUILDING
<br /> hL OR HIS DEPUT' S ARE PfuD
<br /> •--`fi AND FEE
<br /> L
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