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Dec 14 00 08: 23a Ch -is Fisch ( 209'''72-3571 p. 3
<br /> _.`WOoDF EAR" f TEI-HNGLCGIES
<br /> SPECIFIED DECLARATIONS EXPIRATION
<br /> UCENSED CONTRACTORS DECLAPATFON INFORMATION
<br /> f rtwacy estrmr ribs"!run IltSrtesd undw the provisions of Chapter 11(commencing with Section 1940)
<br /> of D1v%IM 3 A the s1M41s Md Protssrlens Cods,and my tion»"Is In yl force and alleci Every permit leaned by the Building
<br /> LlosnM/ Epw1rodan DateOfficial under the provisions of thk
<br /> Date /a--/ `L• Contreafor_;:7i S J-! ni.'r 2dNyYt 1wt n Cads shall expire by ihallatlen and
<br /> baceme nun and Vold K the bulldtng
<br /> OWNEWBUADER DECLARATION Or work authorized by such permh
<br /> I hsfeby am m that I am Tempt from the Cotttlnclor's License law fat the following roe""(Sec. to not commenced whltin t so drys
<br /> 7031 3,Business and professions Cods_Any aft or county which requires a pwmh to construct,situ, from the We of such permN,or it
<br /> improve,deew4fsh,or rspak any slnrctuta.prior to be leausnce,ata*requlres the applicant for such the building or work authorised by
<br /> psrmlt to file a signed statemans triol he is Nowwd puriwnt to the pioulsions of the COnheci0t's such pormlt is tuspanded or
<br /> Lioettee Law(Chapter 1(oommaenetno with Swoon 70%of MAAWoW 3 o1 dra Busin"s and abandanod at any tl*-after the
<br /> proNadon,Code)es shot he M eaNVI Mtetefrom sad the basin for the alleged exompNon. Any work Is commenced for•perlod of
<br /> wsoledon of S"aaon rWj A by any applicant for a permit eubleotr the sp/Iicant to a civil penalty of not 180 days. Work shall be
<br /> more!ban fit hundred donee(3600.00)-): considered abandoned N on
<br /> L as owner of she property.as my wriplayee*whA wage*as Utak soft compdnsstlon,wi:l do the InepecCon has not been approved
<br /> wort,tend Via strUes"is nos tr t rtded or offered for Sala. (fico.70441,Suainese and and rscetded wtihin ISO days.
<br /> Fsafe*eions Cod": The Cetrtrwim-s Cheese Leer dose mrd apply to an owner of properly w1vu
<br /> bugsa at knprovee Uterson,and who dose such work WWA9H or Mtrough Ills sewn employees,
<br /> prevld*d Utet such Improremertls ars not Intended or offered for salt. If,however,the
<br /> In," rg at knpfaimuna d Is sold wl hln*esu year of 001111PIWOM,1010 etwrte-bW1W"r*40 Mw tit
<br /> Muflan of Wowing dirt to did nM build of krgrove fat the purpose Of rile.)
<br /> 0 1,as arose M she praperty,am sadusivery,corf wVng wsth Naena41d contractors to eonstrum the INSPECTION
<br /> prolwt. (341,7044,leainses and preTssome Code: The Contrsclor's Ucensa LAw does not INFORMATION
<br /> Sppfy 19 Sri oWnW of prop"rty who bullde or Improves tharson,and who contracts for such
<br /> projeeta WM S tarWat atl000tractor(e)Ilcsnse pursuant to 1e*Contractor'*Elesnas LAN.)
<br /> UI om srttampt undet Etc. of the SualMas and Ploksston•Cade for the The San Joaquin County Oullding
<br /> tainow"mason: bnspeotton Division has Installed an
<br /> Dain Olrttet automatic reeoeding davkv to
<br /> receive lnspectlon requssis. This
<br /> WORKERS'COMPEN3ATION DECLARATION service will be sysltabis IIs Tours t
<br /> 1 hereby sfftslt under pehahy as psrlwy one of Iht fallowing declneUons: day,seven days a week. Calls*11
<br /> 1 haw S 4 will snainttdn a COMWICS19 e4 tendons to e"Nansure far wotkWo'compenastlort,w be taken off the recorder at 3:00
<br /> Provided for by swtiott 3104 of the Labor Code.for Use pMornuil of the work for which this p.m.every workday and distributed
<br /> pwmk Ir)"Lead for Inspottlan the following
<br /> �j I have lend wed maMtdn vMIKO 'tomtperlsalion Inevfence.40 requlr"d by Section 3100 of Ihs workday.
<br /> Leber Cede,for rtes pwforrtence of Itro weak lot which this permit is Issued. My workers'
<br /> oorrlM (�
<br /> cant
<br /> orumbef s/s: To request an Inspection,please
<br /> C4rrlsr, poticyNumber i 53�aes-oa — tall(209)446.3136. you will be
<br /> ([hit serlfon Itesd riot M ao Is fpr Otte Aunde"d dollars(3100)or 14021- requested to provide the follewing
<br /> ry I ads"Yat As U"petfainalme of this wort for which this psrmlt is ksuod,l 61111M not employ Intormallon:
<br /> U any pweort in WV lrw*eef so as to become subject to tlw WorYne'eempsnaatlon[aw of
<br /> Comwitial,and agree that N I*MUM b"oome sublsot to d%d tawkets'compensation provisions Of 1.Permit Number(Mandatory)
<br /> Swoca 3700 of the LAbos Code,I sluts"hwlth comply with Utoe4 provisions. 2.Your Name
<br /> 3,Job 641•Address and lisarasl
<br /> aftt .`/ i ] d AvpMc.enl --r� Cress Sheat
<br /> WARNING; FAILURETO SECURE WORKERS'COMPENSATION COV[MOE IS UNLAWFUL,AND 4.Telephone Nurlb4e
<br /> 3fi11LL vU6JEC1 AN 11IMPLOYE1f TO CRIMINAL"MALTIE3 AND CML PINES Up TO ONE"UNDRED S.Day tnrpdetlon itrsferrsd
<br /> THOUSAND DOLLARS(Et00,00b),IN ADDITION i0 THE COST bf COMPENSATION,DAMAOES AS 9.Type of Inspecilon
<br /> ppo"DfD FOR IM e[CTtoss 370"OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
<br /> CONSTAUCrOM LENDINQ AGENCY
<br /> i hatrDy aA4rte Wet Lite+*Is,is construction Isnding agency fa the p atteance of 1e*wok tot which
<br /> this penett 1.6-004(S4+a.*007,CHIT Cede)._ PG&E
<br /> Lender's Nems Address
<br /> Cityyew. ghee» INFORMATION
<br /> DW&)ON OF INOUSTRSAL EAF£Ty pERMrr CERTIFICATION POLE Ms 41aksd that vet notify dl
<br /> 1 hereby ourtlty that las escevstlon five(6)of frrare real In depth we which•person Is required persona who will need new gait or
<br /> to desoatd,wilt be reed"M connecUon wig wort SuUnodLed by thio panrtit,and trial via electric service to consult them•s
<br /> buMdittg,siVulctuse,ecarrhMno,injoa Berk or dsmorhfort of 016"rilling llwoof,wig be more to Pieper location of both ensrers.
<br /> reran tatk+y'eti(aa)lions>dYn, (mit.3A Grp.3,Ari 2.lea.341,Tttis 3,CAC.) if your building pleiect Involved
<br /> As ewrLet.bundW,I VM nas employ*My_*to do wort which would fetiuh•a Pot Mil from the vt11l1tes suppilod by POLE.Planes
<br /> IiNidem r of 6wRoUlal lWety,as Rated soave,urdees such Person has a Pat"to do such work contact them at(249)466-asa1-
<br /> from to DhAeiert.
<br /> r-i lNslost DOf inauatrtal Safety Permit No. As s reminder.PG&E and the
<br /> LJ
<br /> telephone COMPaniw 411100
<br /> recommend you Mak"
<br /> I comity Short I have VWW Otis*W_tlon and stat*that the above Information N Convect I agree W arrangements with Cham•e early as
<br /> comply wish r sky and oalrtty beditusntee*end stats Ines 1e11110"SO butldhlp oanstruction,eRd possible to minimus delays In the
<br /> bertby Widwim represnaaUrs s of"t:at my to#RlW upon tit ab4Yi fnemfi0fled property for conrtsctlon of your OW-41CO.
<br /> tnopo~PurpOese.
<br /> Dog AppAo41d
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