The URL can be used to link to this page

Home My WebLink AboutXR2022-2020 - Permits:SNOI11ON00IVIO3dS AEI (13SS33ONd epuaplsaN i!un-al6ulS - L-2d : auoZ asn .. _ X : auoZ POOId • S:ueaa'7:Gp;S'7:Up!S'OZ:;uoid :sNoeq;aSBuIPI!ng 0 : a6eue0 ";;,bs mON/PaPPV : sa!uO;S;O ON :;4BIaH BPIS 90L : BPIB'1 ,bs uol;eua;IV : s;lun;o ON n : sdnou0 Rouedmmo 0 BPIEI 4 ,bs Il/maN/PaPPV ON : auOZ puezeH auld : uogonu;suoO;o adAj 00'000'9L$ : uopenleA uogonu;suo0 S3A : suahjuludS aald 6LOZ uOI;IP3 aPOO :auo4d ssauppV £Z0Z/9/6 : au!dx3'0'M : auo4d uauBlsaO OvMo70M1 : ON AoIIOd : ssauppV ONI+ANVdNCO+30NV2inSNl+AOOIONHO31 I ualuue0 : uappi Paumo ML -ZSL (676) : au04d aOueunsul uopusuadwo0 ,saaNuoM IMU VO'3NIANI N3YV830H1S 9L : ssauppV £ZOZ/L£/SO : auldx3 oll sn8 9LL9-699 (676) : auo4d 9S9Z6 NVnH ND knON : uaaul6u3 L£06900£18 : oil sn8 .V3 'OIaIA OSIIV OOL 'ReMued OIaIA OsIIV 0999Z : ssauppV £ZOZ/0£/b0 : auldx3 Pn Oue!a;uOW 011ION :;ueollddV O!l a;e;S L09SZOL :011 a;e;S u00 OOL6-£SS ((346) : auo4d 9ZOL-L97 (6b6) : auo4d : auo4d 099Z6 VO'HOV38 999Z6 VO'OF31A 999M VO'Of31A lbOdM3N 00L# NG OHVHOLIO L£OZ : ssauppV OSI"lV OOL# AMYd Of31A OSIIV 0999Z : ssauppV OSIIV M31S AMYd Of 31A OSIIV 0999Z : ssauppV H13NNMY IYS2d3W31N :;3a;!43uV 011 Sid301lf18 3WOH OU : uO;M;uo0 011 `JLZVI : uaum0 lid 301SN1 'SNOT 13Hd W3NIl ,90L X HOIH 4 - IIVM `JNINIV13ii :3dO0S 1,00V8 NOISIA3a b V1130 : uO!;dlu0sa0 9101 LZ Yl8 S1HS13H 12i0dM3N Ol O0V 1SLlld'di V : OsaO IeBal 210 VNnV1V0 Y9V : ssauppV qor SV3UV llV NI SAVOIIOH ONV AVOWS NO NHOM ON ONV SV3NV AlISN30 HOIH NI AVONnS Ho AV02dnlVS NO 3SION 031V1321 NOIlomJiSN00 ON 31VO 3ONVf1SSI IVNISRIO W021d S2!V3A £ NVHl N31VI ON lns'N01103dSNi OIIVA 1SVI 2dO 3ONvnSSI N31dV SAVO 09L 32iIdX3 SlIIN"d f : eajV uol;oedsul ZZOZ/EO/80 : a;e❑ ponssl : ON MOa40 ueld OZOZ-ZZOZ2IX: UW10d OW00 10410 - sse10 >IuoM ddS - adA1 uol;eupwo0 suol;aadsuI/A06 eopeoguodmau 55Z£-7b9 (646) :auo4d slsanbaa uopoadsul 99ZE-779 (676) :auogd jalunoo 8.w9d 099Z6 Vo'goeog liodmaN'anpo Jaluao 0IAI3 OOL uoISIAIo bulplmg-luawpedao luawdolaAao R;Iunwwo0 yaeag ?rlodmON 10 APO w D �yodm3N OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt frorn the Contractors' State License Law for the reason(s) indicated below by the ofineckrnark(s) I have placed next to the applicable item(s) ,Section 7031.5, Business and Professions Code: Any city or county that requires a permit . to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for .he permit to No a signed statement Ihot he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000)of Division 3 of Ilia Business and arofessions Code) or that he or she is exempt from Iicansure-and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant tc a Cv'I penalty of not more than five hundred dollars ($500): L, as owner of the property, or my employees with wages as their sole compensation, will do Iall of or (J portionsof the work, and the structure Is not intended or offered for sale (S,.ction 7044, Business and Professions Coda: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, +imvlded that t'hc improvements 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 h was not built. or Improved for 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' Stale License Lew does not apply to an owner of property who builds or improves: thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), El I am exempt from IGenSure under the Contractors' State License Law (or the following reason: By my signalure below I acknowledge that, except for my personal residence in which I must have resided for at least one: year prior to completion of the.' improvements covered by this permit, i cannot legally sell astructure that I have built as an owner-bulidar if it has not been constructed In its entirety by licensed contractors, I understand that copy of the applicable law, Section 7044 Of tho Business and Professions Code., is available upon request when this application is submitted cr at the following Web site::h0p:lfwwwJeginfo.ca.gov/ealaw.html. Signature of Property Owner Or Authorized Agent Date - LICENSED CONTRACTOR'S DECI,.ARATION ,r,, I hereby affirm under penalty of perjury that am licensed under provisions of C!hapler 9 (commencing with Section the. Business and Professlo s C m r Ilce�ut)1 full rce and effect. License Class License No Dote Contractor Signature X P/ 1 vVORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT. AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANO DOLLARS IEtsd„ s0), IN ADOrr O THE COST OF COMPENSATIONI DAMAGES AS PROVIO ED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury ore of the following. declarations: 1 have. and will maintain a certificate of consent toself-Insure for workers' compensation; issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thi performance of the work for which this permit Is Issued. Policy No, have and will maintain workers' compensation Insurance, as required by Section 3700ofthe Labor Code, for the performance of the work for which this permit is Issued. My workers' compareatiol trance carrier and policy number are: 'ter policy Number Expiration Date le of Agent Phone # certify I s that In the a sub arlce hof eth Work or which is permit lelssof Si shall not employ any personinany manner with c as to become subject to the workers' compensation layv i1California, and agre ll I should become subje to the ker compen t n vu'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iaiura of Applrcant� �_ .. _ .... -- Date, I hereby affirm under penalty of perjury that there Is a construct on ;ending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cede). Lender's Name Lenders Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. 1 have read this application and the information I have Providon Is correct. I agree to comply with all applicable city and cou ty ordina a a 1,J 4 relatin to building construction, I authorize representatives of this city or county at ter th ov iropert or Inspection purposes. SI nature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized A genl's Name / 1(.i Da[e ACTION DATE BY { DECLARATION OF COMPLIANCE. Wi V CODE OF FEDERAL FOR OFFICE USE ONLY i11 REGULATIONS PART 61 OF TITLE 40 AND.AQMD RULE 1401 PERMIT EXPIREq I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED MEPA All required alarms, latches gates and fences which serve as part of a pool/spa barner,.shall PERMITEXTENDED EIAQMD be Ili place prior it) approval to fill pool/spa &'shall remain In place &. be. maintained for the EPERMIT FINAL �- l � Z'j ASBESTOS NOTIFICATION IS NOT APPLICABLE TO life of the pool. CERTIFICATE OF b PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE;