HomeMy WebLinkAbout1207 CARLSBAD VILLAGE DR; ; 80-142; PermitCONSTRUCTION LENDING AGENCY1 hereby affirm trial there is a construction !ending agency for the performance of the work forwhich th« permit Is Issued (Sec 3097, Civil Code)o ' CERTIFICATE OF EXEMPTION FROMWORKERS COMPENSATION INSURANCE(This section need not be completed If the permlt is lor one hundred dollars ($100) or less)I certify that in the performance oi the work forwhich this permit Is issued, I shall not employ anyperson In any manner so as to become subject tothe Workers' Compensation Laws of CaliforniaNOTICE TO APPLICANT If alter making this Certiflcate of Exemption you should become sub)ectto the Workers Compensation provisions of theLabor Code you must forthwith comply with suchprovisions or this permit shall be deemed revokedlisllillE GRANTING OF THIS PERMITCAREFULLY EXAMINED THE COMPLETY CERTIFY THAT ALL INFORMATION HHER CERTIFY AND AGREE IF A PERMITHY AND STATE LAWS GOVERNING BUILCIEDHEREINORNOT \ ALSO AGREE TCHE CITY OF CAHLSBAD AGAINST ALUr m n C z >
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APPROVED BY DATE1•AN OSHA PERMIT5 0 DEEP AND DESTRUCTURES OVEO „.I J 0)
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MOBILE HOME PERMIT^ELECTRICALV contractor s License Law)1 am exempt under Sec a 4 P C!!!I|I^ iilii[ii|H!H IflillylfPfpi§|^«£as 35i35l|2?3|g-^ -^^JS'asIls5-"*-^•S- J 3 ,_ n 0 -g o^nSSo^ogSISs ni&S,(°S5»g.3Scl.S33.B)mI|IIj|l |ii*f|[lf!|hl PHlilHllliiisi!i!|il!!f!lili!l!irooz-iRACTOR
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Ol LICENSED CONTRACTOR'S DECLARATION1 hereby affirm that 1 am licensed under provislons of Chapter 9 (commencing with Section7000) ol Division 3 o( the Business and Professlons Code and my license is in fult force and effeet 1zo^^rrC
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