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Home My WebLink AboutH2022-0374 - Permits:AS (33SS30ONd (N s �J p- q;JoN jaUodrAaN - Od : euoz asN X : auoz Poold clJ� 0L:Jea2J'9:aplS'9:apls'GL:;ua3 :s)ioeq;agBu!pllnEl sdnou0 /I3uednoo0 #16PoW A : auoZ pJezeH aald- : uol;oni;suoo;o adAl jaun;oe;nueWl' ON. -: slal3luudS ajld 6LOZ : uo!;!P3 aPoO aildx3 •O ,M ON Roggd jalijeo uol;esuedwoO eoueinsul ,sje)ljoM ZZOZ/L£/ZL aj dx3 oll sne 6090-629 (6176) : auogd SOL9h00E18 o!I SnB 889Z6 VO `V1RJV02JVW V1NVS OHONVd 99L#AMHd OINOINV LZL£Z : ssaIppV 4ZOZ/O£/40 : aj!dx3 orl S301MJ3S MlV SIM3I :;ueo!IddV MZL6 : oll a;e;g u03 6090-689(6176)'.-: :auogd :auogd 889Z6 VO 'V11aV0NVW V1NVS OHONVH 99L#AMNd OINOINV LZLEZ ssauppv 099Z6 VO `HOV30 iMOdM3N AVM M3-LMOdM'9N 9H4 : ssauPPV S301AH3S d1V SIM3Iao;aea;uoO IHSVAV90N NOG : uaumo .O3]M dVO d00?Jd 213dViVi.30VNHnzi'g 11Nn o/V inO 3E)NVHO H031N : uol;duosa0 OE 10-1 A71 L L09L a1 N : osa❑ leBal AVM 2J31MOdM3N 9L4L : ssaippV qor SV9MV ]IV NI SAVGIIOH GNV AVGNnS NO MOM ON GNV SVMJV A11SN3G HEJIH NI AVGNns 2i0 AVGNLIIVS NO 3SION G31VI32i NOinmt 1SNOO ON 31V0 33NVf1SSI IVNIDIMO WOH-A SNV3A £ NVHl N31VI ON ills `NOIlO3dSNl OIIVA 1SV l 210 3ONvnssi N31dV SAVO 086 3MIdX3 S.LIWN3d 4 : eajV uolloodsul Zzozlzz/Lo : o;ea panssl suogo@dsuyno6 eog0eogl1odmou `aaoe �7s u8g;0 : sselO;laoM 991E-V49 (646) auogd s;sanbaa uogoodsul 881E-449 (646) :au6gd jalunoO;lwJad }� [+ : ON 13843 ueld 09916 VO'goea8 >rodmaN 'anpG 10;uaO 01A10 001 V�40�ZZOZH .;1waad leoiueg3gw II II II �II II II III IIIIII III uo1s1A1G Bulplln8-;uawliedap#uawdolanaO l;IunwwoO 9 p� yoea8 :podMON 10 ANO �oen�3a i hereby affirm under penalty of perjury that t am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have platted next to the applicable Remit) often 7031.5. Business and Professions Code: Any city or county that requires permit to construct, alter, Improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to theprovisions of the Contractors', State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessions Code) or that he or she Is exempt from ficensure 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 more than five hundred dollars ($5001, 1, as owner of the property.., or my employees with wages as their sole compensation will do L) allat or L) portions of the work, and the structure is not intended or offered for sale (Section 704, ;mess and Professions Code: The Contractors' $rate License Law does not apply to an owner of property who, through employees' or personal effort, buittls or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was notbuilt or rovedfor the. purpose of sale).; I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project. (Section 7044, Business and: Professions Code:. The Contractors' State License Law does not. ly to an owner of property, who builds or improves thereon, and who contracts for theprojects with a licensed Contractor pursuant to the Contractors' State License Law), I am exempt here licensure under the Contractors' State License Law for the foltowing reason: my Code, is a4 or one: year prior to complation .1 understand that a copy of hit -permit, I .cannot of the Business and LI4Cry =L` 4WlI 1Tlh I VR 0 VCC ,L 11S I IWVI I hereby affirm under penalty of perjury that am licensed under provisions of Chapter 9'(commencing with Section ) o Division 3of the Business and ProVOD de, aed myliit s Inful! farce and effect. License Class License No Date 2 contractor Signature WORKERS' COMPENSATION DECLARATION �NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL. PENALTIES AND CIVIL FINES UP TO ONE HUNDRECOLLARS (100.0001. IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 370&OF THE LABOR CODE. {NTEREST,ANDATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 711 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th e��y�Eo,m��(�a�nce of the work for which this permit is issued. Policy No. ,.. h,bQve and wi0 maintain workers compensation insurance, as required by Section 3700 of the labor Code,for the performance of the work for which :this . permit is issued. My. workers' compensatiot insurance carder and policy number are: is of Agent' certify that, in the pi , If I should become Hhure of Applicant _ Policy Number Expiration Date Phone # areby affirm under De nP Y'of perjury that there is a com )der`s Name / my signature below, Akedify to each of the following: I am the prapertyowner or authorized to act on the. on I have read this application and the information I.have I agree to comply with all applicable city and county or I authorize representatives at this city or county t/eny ACTION VERW E&PIBED CERTIFICATEOF OCCUPANCYISSUED DATE. I By. permitis issued, I shall not employ any person in anymanner so. as to become subject to the workers' compensation laws of California, and agre t provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisionIs. r Date AG:NCy jetion lending agency for the performance at the work for which this permitis issued (Section 3097, Cl it Code):. Lender's Address- ler's behalf. is correct and state 19 purposes. FOR All required alarms, latches gates and fenceswhich serve as part of a pool/spa barrier, shall be In place prior to approval to fill pool/spa & shall remain in place & be maintained for the IS NOT APPBLE TO life of pool