30143447 - Permit - Laserfiche WebLink

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INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII NER DEl CAR,ATION I hereby affirm undet penalty of periury that I am exempt form the Contractors' License Law for the following reason (Sec.7031.5 Business and Profession Code): Any City or County r.r,hich requires a permit to construct. alter. improve, demolish or rcpair any structure. prior to its issuance. also requires the applicant fcrr such permit to file a sigrrcd statement that hc or she is licenscd pursuant to the provisions of the ('ontractor's Licensed Law (Chapter 9. Commencing rvith Section 7000 of Division 3 of the Business and Professions Code) or that hc or she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031 ..5 by any applicant for a pcrmit subjects the applicant to a civil penalty of not more lhan five hundred dollars ($500). !9 f . .r owner of the property. or my employees with wages as their sole compensation. will do the work and the strucnrâ‚¬ is not intendod or offered for sale (Sec.7044. Business and hofessions Cocle: The Contractor's License Law does not apply to an owner of the fpcrty who builds or improve thereon. and who does such wort himself or herself or through his or her own cmployees. provided that such im;nrrvemots are not intended or offerecl for sale. lf. horver,,er. the building or improvemcnt is sold within one year of complaion, the Os'ner Builder will have the burdcn of proving that he or she did not build or improve ilre propertv fcn the purposc of sale). fO t. .r owner of the property'. am exclusively contracting rvith licensed contractors to constnrct the project (Sec. 7044. Business and hofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves lhereon. and rvho contracts for such projects u'ith a Contractff(s) licensed pursuant to the Contractcr's License Larv). !o-l ". exempt under Section -- . B. & P.C. for this reason. WORKT'RS' COMPFNSATION NF'CI ^ RATION I hereby affirm under penalty of perjury one of the following declarations: ! t n"". and rvitl mainrain a Ccrrificare of Consenr ro Self-lnsure for workers' compâ‚¬nsation. as providcd for by Section 37fi) of thc l-:tnr ('ode. for the performarrce of the work for which the pennit is issued. YES _ I have and will maintain wor*ers' compensation insurance. as required by Section .1700 of the Labor Code, for the pcrformance of the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are: . Ncw Harprhlrc lnr. Co. L arner: 038301 552 0710112022_Expires: __ _Policy Number: NO _ I certify that in the perfonnance of the work for rvhich this pennit is issued. I shall not employ any person in any mann6 so as to trc<ome sub.iect to the rvorkers' cornpensation larvs of California. and alree that if I should become subject to the workets' conrpensation provisions of Section 3700of the Labor Code. I shall. forthwith comply rvith those provisions.. WARNING: Failure to secrre rvorters' compensation coverage is unlarvfirl. and shall subiect an employer to siminal pcnalties and civil fines up to one hundred thousand dollars ($100,000). in addition to the cost of compensation, damages as provided for the Section -1076 of the l-abor ('ode. interest and attomey's fees. LICI.-NSF'N CONTR.ACTOR, NE(' I AIIATI('IN I hereby alfirm under penalty of pcrjury that I am licensed under provision of Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. c30 I-icense Class: 9E7860 l-icense Nurnber (.ONSTRII('TION I FNNING AGFNCY I herebv affinn under pnalty of perjury that there is a construction lending agency for lhe;rrforrnance of the u'ork for which this permit is issued (Sec. -1097. Civ. C.). Lender's Name: Lender's Address: APPI I('ANT DTCI ARATION I herebv aflinn undel penalty of perluw one of the followrng declaratrons Denrolilron Pernrits-Asbestos Notification Federal Regulanons (Title 40, Part6) !_o_ Required Letter of Notification Yl1 f cefliry that the federal regulations regarding asbestos removal are not applicable to this project. Tt t cerliE/ rhar I have read this application and state that the above information is correct. I agree to compty with all City and County ordinances and State l-arvs relating to building construction. and hereby authorize rcpresentatives of this City and County to enter upon thc above mentioned property for inspection purposes. Reroof Roof (Diaphragm Sheathing/Frame) Structural Final Plumbing Under Floor I Under Slab Rough Shower Pan / Tub Test Water Service Sewer / Sewer Cap tl ^., Gas Air Pressure Test "7 l,.l7r L.-tg,r Plumbing Final 1fL /2,L,a(51- Electrical ,, Service (Meter I Panel) Grounding / Bonding Rough Electrical Final Mechanical Gas Air Pressure Test Rough Piping (HW,CW, etc.) Exhaust Ducts Mechanical Final Notes, Remarks, Etc. 7