101105859 - Permit - Laserfiche WebLink

Home Browse Search

BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION I hsâ‚¬by affim unda pemlty of pcrjury that I dn cxcmpt from thc Contractos' Licwc Law for thc following rcetr (54.7031.5 Buincs and Profsion Codc): Any City or County which rcquirs a pqrnit to comtrucl. alt6. imprcvc, dmolish or repair uy structuq prior to its issmcc, also rcquirB thc applicet for such psmit to file I signcd stalm@t that hc or she is licmsl p|edr to thc provisio$ of thâ‚¬ Contractor's Licmsâ‚¬d t w (Chaplo 9, Commcncing wilh Setion 7000 of Division 3 of thc Bsinc$ ild Prcfesions Codc) or that hc or she is qempt thqefrom ild the basis for the allegcd qmption. Any violation of Serion 7031.5 by oy applicantforapcmitsubj*tsthc applicattoacivilpmltyofnotmorcrhilfivchundrcddollm($500). I _1. as owner of the property. or my employees with wages as their sole cornpensation. will do the work and the structure is not intended or offered for sale (Sec.7044. Business and Professions Codc: The Contractor's License Larv does not apply to an owncr of the property who builds or improves thereon. and who does such worft himself or hersclf or through his or her own employees, provided that such improvanents are not intended or offcrod for sale. I[, howet/er. the building or improvernent is sold within one ]er of complaion. the Orvner Builder will have the huden of proving that he or she did not build or improve the propoty for the purpose of sale). _1. as owner of the propâ‚¬rty. am exclusively contracting with licensed contractors to construct the project (Scc. 7044, Bwiness and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such p,rojects with a Contracto(s) licersed pursuant to thc Contractor's Liccnse taw). -IalnexemptunderSection-.B.&P.C,forthisreason. WORKERS' COMPENSATION DECLARATION I hercby affrnn under pcnalty of perjury one of the following declarations: -l have and will maintain a Certificate of Consent to Sclf-lnsure for workers' compensation. as providod for by Section 3700 of the Labor Code. for the po'formancc of the work for which the perrnit is issued. _l have and the work for \ will maintain workers'as by Section of the Labor Code. for the performance of permil is numbcr are: Policy _l certi& that in the perforrnance of the work for rvhich this perrnit is issued. I shall not cmploy any pcrson in any manner so ,ls to become subject to the workers'compensation larvs of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwith comply with thosc provisions. WARNTNG: Failure to secure workers' compensation coverage is unlarvful. and shall subject an anployer to criminal peiralties and civil fines up to onc hundred thousand dollars ($100.000), in to the cost of damages as for the attorney's fees. I hereby affirm under pcnalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. Liccnse C()NSTITT](]'TION I,T.]NDI N(; AG I.:N(]Y I hrcby affm undr penalry of perjury thal the is a coNtructiotr lcndiag agocy for thc pqfot:lmcc of thc work for which this pqmit is isucd (Se. 3097, Civ. C.). Lender's Narne: Lender's Address: APPLICANT DECLARATION I hereby affinn under penalty of perjury one of the following declarations: Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6) _Required Letter of Notification -l certi& that the Heral regulations regarding asbestos rernoval are not applicablc to this projed.\ _l certi& that I havc read this application and state that the abovc information with all City and County ordinances and State Laws relating to building above mentioned property for inspection Applicant or Agent I'ermilee name and and County enter the Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor S u bfloor/Ve nUI n s u Iatio n Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Itlasonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif I FINAL tol'LllLl OtktuY 'l Certificate of Occupancy !- I Notes, Remarks, Etc. Carrier:- _Expires: