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CITY OF STOCKTON PHONE: (209)937-8561 CITY OF 24 Hr.Inspection Request STOCKTON COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION,CITY HALL 209-937-8560 PERMIT STOCKTON,CALIFORNIA 95202 Permit No: BP21-02532 Description of Work: Arco AM/PM Gas Station and Car Wash Issue Date LICENSED CONTRACTOR'S DECLARATION Permit Type Outside City Limits I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. Category Commercial License Type:A.B.Hag license Number: Date:755898!4121/2022 Contractor.,$aVidgQ Qonstruction InMockton Bus.Lic.No: 755a$§ Permit Address 2431 S MARIPOSA RD 17130024 OWNER-BUILDER DECLARATIONS Parcel No. 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5.Business and Professions Cade: Any city or county which requires a permit to Owner BLINCOE,JAMES E TR construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the 14501 WELLS LN applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Contractor's License Law (Chapter 9 commencing with Sec.7000) of Division 3 of the LODI CA,95240 Business and Professions Code) or that he/she is exetrlpt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to Applicant BUNCOE,JAMES ETR civil penalty of not more than five hundred dollars($500): 14501 WELLS LN LODI,CA 952401, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044) Business and Professions Code: The Contractor's License Law. does not apply to an owner of property who Contractor buNs or Improves thereon, and who does such work himself or through his own empkiveis, provided that such improvements ate not intended or offered for sale. If, however, the butkl<ng or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.) I, as owner of the property, am exclusively ua s;tilig with licensed contractor(s) to construct the project (Sec. 7044, Business and Profes.10 Cade: The Contractor's License Law Valuation does not apply to an owner of property who builds v proves thereon, and who contracts for such projects with a contractor(s)licensed pursuant to the[on v License Law) Special Notes and Conditions I am exempt under Sec B&P,C.f reason _ Required inspections: Date: 4/21/2022 Owner: Additional inspections may be required depending on the NOTE: To protest the a any development fee, dedication, reservation or scope of work for your project;please contact a Permit other exaction imposed on your ect, you must file written notice with the City Clerk's office within 90 days after pproval of the project or imposition of the fees, Technician or your Building Inspector for additional dedications, reservations or athe exactions stating that the required payment is information. tendered or will be tendered when due, or that any conditions which have been imposed Potential additional inspections: are provided for or satisfied, under protest, along with a statement of the actual elements of the dispute and the legal theory forming the basis for the protest. WORKERS COMPENSATION DECLARATION _ I hereby affirm that I have a certificate of consent to self-insure, or a Certificate of Worker's Compensation Insurance,or a certified copy thereof(Sec 3800,Lab.C.). Policy Number: Company: Certified copy is hereby furnished.Expires: Certified copy is filed with the city building inspection department Date: 4/21/2022 Applicant: Savidge Construction Inc CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE This section need not be completed if the permit is for one hundred dollars($100)or less. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, Date: Applicant: NOTICE TO APPLICANT: If, Rer making this Certificate of Exemption you should become subject to the Workers' Com tion provisions of the Labor Code, you must forthwith comply with such provisions or this permit s I be deemed revoked. I certify that I ha ead this application and state that the above information is correct. I agree to comply wit a ily and county ordinances and state laws relating to construction. I hereby authorize re tives of the city of Stockton to enter upon the above mentioned property for irsspect10 ses. SIGNED: PRINT NAME: Robert Velasco Street address numbers must be posted before any inspections will IV APPLICATION APPROVAL be made. THIS PERMI DOES NOT BECOME VALID UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS Smoke detectors and Carbon Monoxide Alarms will be required in DEPUTY AN ES ARE PAID, existing dwellings when a building permit is required for alterations, repairs,or additions exceeding a$1,000 valualion. Sionature: r� THIS PERMIT SHALL BECOME VOID AND WORK SHALL BE CONSIDERED B DONED IF AN INSPECTION HAS NOT BEEN RECORDED AND APPROVED WITHIN 180 DAYS