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Home My WebLink AboutXR2022-2716 - Permits'13di 0 : 6p1a '4 "bs ltl1Ol 0 : a6ejeO •g •bs Mary/pappy : 6PI8 "8 •bs uol;eJa;IV : 6PI8 "4'bs IJJMaN/POPPY 00'0$ : uol;enleA uol;onj;suo0 :auo4d ssaippv SN0Il10N00 1V103dS abpla UodmaN - Od X m :Jeaa 'S :ap!s 'S :ap!S 'o :luaj Z' : salao;S;o ON 1,;: : s;iun;o ON ON : auoZ pJeZBH ail j <' ON : siapluudS an j CJ/1J/ fIfIY'l jau61sa0 _. . . I. E8WEOM6V -. :oNAo!loda,. 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License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) ction 7031.5, Business and Professions Code: Any city or county that requires:a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License. Law (Chapter 9 (commencing with Section 7000) of Division 3,of the Business and fesslons Code) or that he or she is exempt from lieensure, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of mnrR than five hundred dollars f5500{, I I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions oft ;iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through irovements are not intended or offered for sale. It however, the building or improvement is sold within one year of comf ,roved for the purpose of sale). h as owner of the property,am exclusively contracting with licensed Contractors to construct the project (Section 7044, Ay to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractoi I am exempt from licensure-under the Contractors' Stale License taw for the following reason: my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one r a structure that I have built as an owner -builder if it has not boon. constructed in its entirety by licensed contractors, l ur rfessions Code,isavailable upon request when this application is submitted or at the following Web siteihUp /Avww.loglr affirm under penalty of pedurythetI am licensed under provisions of Chapter 9 (commencing with Section :t. License Class. License No Date 'RS' COMPENSATION DECLARATION FAILURE TO SECURE ,m�7Pil:dJ1 hereby affirm under penalty of perjury one of the following declarations: 7 I hav rid will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director arfor nee of the work for which this permit Is issued. Policy No. eve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the 1 urance carrier and policy number are; ;arrier _. policy Number ie of Agent certify that, in the performance of the work for which this permit is issued, I shall not employ any person in , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Coded I �reby affirm Under penalty of perjury that there is Ones Name my. signature below, I cattily teeach-of the. ficlov I am the property owner or authorized to act on I have readthis. application and the information i agree to: comply with all applicable city and cc I authorise representatives of this, city or county DATE tending agency for r's-behalf. correct iormance of the work Address d flu d'mgconstruciior inspection purposes, Print Property Ownr ODE OF FEDERAL FC AQNID RULE 1-6 4HESTOS NOTIFICATION IS NOT APPLICABLE TO vc-'I` PROPOSED DEMOLITION work, and the structure is not intended or offered for sale (Section 7044, pleyees'' ar personal. effort, builds or improves: the property, provided that the ion, the Owner -Builder will have the burden of proving that it was not builtor and. Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). Date. Division 3of the Business and Professions Code, and my license is in full force ContractorSignatu ES AND CIwL. FU/ES UP TO ONE HUNDRED THOUSAND DOLLARS t5100.0LIM AEDMON Tlt;; e se � w• •• es es Industrial Relations as provided tar by Section 3700 of the Labor Code, for 141 „ iormance of the work for which this. permit is issued, My workers` dompensat• sees• • . Date o as to become subject to the workers' oompensation taws of CodfornTa. and 8tre e„ comply with. those provisions, .... Date this permit is. issued (Section 3097,. Civil Code),