30143746 - Permit - Laserfiche WebLink

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INSPECTOR RECORD SITE-WORK DATE ID/SIG COMMENTS OWNER BUI1 NER DF'I C^RATTON I hereby affirm under penalty of perjury that I am exonpt form the Contractors' License Law for the following reason (Sec.7031.-5 Business and Profession Code): Any City or County which requires a permit to construct. alter. improve. demolish or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signcd statement that he or she is licensed pursuant to the provisions of the Contractor's Licensed I":w (Chaptcr 9. Commcncing with Section 7000 of Division -1 of the Business and Professions Code) or that hc ff she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 70-j 1..5 by any applicant for a petmit subjects the applicant to a civil penalty of not more than five hundred dollars 1$.s00). !--O-1. .r owner of the property, or my anployecs with wages as their sole compensation. will do the wort and the structure is not intended or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does not apply to an orvner of the propâ‚¬Tty who builds or improves thereon. and rvho docs such worft himself or hcrself or through his or her own employees, provided that such imp,rovemcnts are not intended or offered for sale. If. however. the building or imp,rovcment is sold within ofle year of complaion. the Owner Builder will have the burden of p,roving that he or she did not build or improve tre properW for the purposc of sale). !9-1. r. owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Pr,ofcssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's l-icense Law). No I arn exempt under Section . B. & P.C. for this reason. WoRKF'RS' COMPFNS^TION nrcr AIL{T|ON I hereby aflirm under penalty of perjury one of the following declarations: !t f,rr. and witl maintain a Ccrtificate of Consent to Setf-lnsure for workcrs' compensation. as provided for by Section 3700 of the Labor Code. for thc performarrce of the work for which thc pcrmit is issucd. YE8 _l have and will maintain workers' compcnsation insurance. as required by Section -1700 of the Labor Code. for the pcrformarrce of the work for which this pcrmit is issued. My workers' cornpensation insurance carrier and policy number are: Socurltv Natlonal Carrier: swc13073E0 Policv Number: 11t23t2021 Expires: NO _ I certifu that in the performance of the rvork for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subiect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.. WARNING: Failure to secure wortâ‚¬rs' compensation coverage is unlawful, and shall subiect an cmployer to criminal penalties and civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compcnsation. damages as providcd for the Section 3076 of the Labm Code. interest and attomey's fees. LI(' F'NSF'N CONTRACTOR NF'CL ^ RA'TI(TN I hereby affinn under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. c2GC3C License Class:_7t4495 License Number CONSTRTICTION I FNNING AGTNCY I hereby affirm under penalty of perjury that there is a construction lending agency for the perforrnance of the work for which this permit is issued (Sec. 3097. Civ. C.). Lender's Name: _ l-ender's Address: APPI lC^NT nFCl ^R"ATION I hereby affirm under penalty of perjury one of the followrng declarations: Demolition Permits-Asbestos Notificatron Federal Regulanons (Trtle 40. Part6) !1 Required Letterof Notification VEB f certi$/ that the federal regulations regarding asbestos removal are not applicable to this project. tl t "*i5, ,h", t hruc @d rhis applicarbn and statc that thc abovc infomation is corct I agc to comply wih all City ard Couty ordinarcG and Statc trws rclating to building co6tnrc1bn, and lmby authoria rcpGstativ6 of lhis City tnd County lo 6t6 upon thc abov. rcntiond prcpcrty for inspction purpos. Reroof Roof (Diaphragm Sheathing/Frame) Structural Final Plumbing Under Floor I Under Slab Rough Shower Pan / Tub Test Water Service Sewer / Sewer Cap Gas Air Pressure Test Plumbing Final tt?uZ . DIW Vl Electrical I 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.