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irlrr Ufo Sfr slni *,rftc.g
<br />^d,ilriltdorr
<br />fro c*o;ar t*r..tlr rt oc e.r*l A,rn"rlB, rnd $€ Calbrnia Divitill o,lndlEtd Acclant3 l*o t rxlcrt.d I rEy cotlad tE CCilUda CqtfaEbr'Srb tirt'e Bo6d (CSl,l) at r.8(xr-
<br />32r aSLB (2752) a t&.fhg.g!! h. mo.! i oona..n Sota br.€d qltsacbt.
<br />fl!-f O. t an mrc ot rd cql.s{ b a.t oti,rt€ €older tuiHirig pfidt appl€d br h my nrno. ar|d urd rbrd tlat I an tlcptf, bo.ly and lha,|(iay ,rrponlab lb. Fopos€d drstudiro adn fy at thG ,ofqyrng a4
<br />JkNl r . t aoreG olat a th€ party l€gafy and finaftially r€6porrrbb lor thr! p.!pos6d co.E8rr.lbo aclrr/ty. I ra abiro b, d
<br />app6c.trb bt^,3 arld requirenronts tiat govem Osne.Suiusrs as Bei as ompbyers.
<br />.ftC f Z. f "gr* O *ffy th6 issu€. ot this bm irirnedral€ly ol ary addilirns, doblirrs o. chsng€s b a'ly ot lho in'orr|ratioi I
<br />have Foviled on this bm,
<br />Li:e'ls€d coot-aclors ar! ,ggdated by lariu desiJned to prote.i tno public. lf you co.llr&t wifi Gomoon€ wtro does not hay. .
<br />l-ens€. the Con!_adorE' Stale Li:ens6 Boatd nEy be unabb to assisl you wih any finaflcial bsg yoo may 6u6t8h as a reau[ of
<br />a cofiplaint Your only tertcdy against uhltcensed Contiaclors may b€ in civil oourt lt ls aho irnpo.tant tor you io urderEtard
<br />0!at if an unli:ens€d Cmtrador or arnploys€ of that individual or firm b iniured while working on your Foperty, you may be hGld
<br />liaug b. dfirages. l, Fu oblain a pGtrnit as Oyvne.€uilder and *ish to hire Conbdols, you rrill be ,aspo.libb fo. vedfying
<br />whctle or nol those Coflfadors are property licansed and the smls of their t rorters' coripensaton insuEhoe coverags.
<br />Signan re ot ttoperty otnn€f,Oate ,E
<br />Par name o, Ouner k}t;l,zevJ )4o
<br />AUTHOR|ZATIOTI OF AGE}|T TO ACT ON PROPERTY OUTNER'S BEHALF
<br />Erduding the Noltce to Property Owner, the execllIidr ot which t understard is my personal rcsponsibility, I heeby authonze
<br />tE foIowing perso.t{s) b ac{ 63 riry agent(6) to apply tor, s(ln, and 6le the docuoents necessary b obtain an Orner€uilder
<br />Permt b. my projer:t
<br />Scope ot C,onsurrclbo P,q€art (oa Oescriplirn o,
<br />Prq€d Locatirn or ArHag$:ilL G,O (ft t 1
<br />Naft€ ot Artho.iz:ed A96nt l^tl, i,D
<br />Addr€s6 o, AuttrdEed )c "iz6 z-n
<br />Phon€ Numbe, ot ArtrE iz6d A0oot q Ziz- g
<br />I d€c.lare under peflaty of p€qrr.y lhal I arn the propeny osner to. ihe addre6s tsted above and I persoidty f[ed olt lhe above
<br />info.matbn a , cerlity i5 acorracy
<br />Propqly Orne/5 S€nature
<br />2z-"2.:2;
<br />PrElt Nant€ ol OYUtl€t:
<br />No,.: A cqy ot th. arrr.t . dy.l, ticaa,lotu tl,''r,k,.don, or oah.r vadlcaloo accq,,,U. to thr lgcocy tr ar-qulrd b b lrt,r,ntd urraD th. p@mlt l, lsru.d ao v.ttty rhe yopcrty own.ft .lg/,trlrn,rt,
<br />,9otei
<br />t topettv owner's slona,ure.
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