HomeMy WebLinkAbout1255 CYNTHIA LN; ; 80-62; PermitCONSTRUCTION LENDING AGENCY1 hereby affirm that there is a construction lending agency for the performance of the work forwhich this permit is issued (Sec 3097 Civil Code)CERTIFICATE OF EXEMPTION FROMWORKERS COMPENSATION INSURANCE(This section need not be completed if the permit is for one hundred dollars ($100) or less)1 certify that in the performance of the work forwhich this permit is issued 1 shall not employ anyperson in any manner so as to become subject tothe Workers Compensation Laws of CaliforniaNOTICE TO APPLICANT If after making this Certificate of Exemption you should become subjectto the Workers Compensation provisions of theLabor Code, you must forthwith comply with suchprovisions or this permit shall be deemed revokedOF THE GRANTING OF THIS PERMIT-•v,i
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m 1 HAVE CAREFULLY EXAMINED THE COMPLETED AFHEREBY CERTIFY THAT ALL INFORMATION HEREONFURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUECOUNTY AND STATE LAWS GOVERNING BUILDING CCSPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVELESSTHE CITY OF CARLSBAD AGAINST ALL LIABILPLICATION AND PERMIT AND DOIS TRUE AND CORRECT AND 1D TO COMPLY WITH ALL CITY>NSTRUCTION WHETHERINDEMNIFY AND KEEP HARMTIES JUDGMENTS COSTS AND•AN OSHA PERMIT5 0 DEEP AND DESTRUCTURES OVE31 p V)
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Vj ^ WORKERS COMPENSOTlONfDECL/A 1 hereby affirm that 1 nave alertificSent to self insure or a certificate cCompensation Insurance or a certthereof (Sec 38g8.j^bc*Coo<i)Ot:oEM£" O 7T~ O CD53
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3o>COi ply to an owner of property \*ho buiprov&s thereon and who contracts forjects with a cqntraclor(s) license pursicontractor s License Law)1 am exempt under Sec0 1 3 3 owner builder will have the burden of proving thathe did not build or improve for the purpose ofsale)_il as owner of the property am exclusively contracting with licensed contractors to constructthe project (Sec 7044 Business ?nd ProfessionsCode The Contractor s License Law does not apTJI
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MOBILE HOME-NEW CONST EA AMP/SWT/BKRAWNINGMECHANICAL:
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INSPECTION EACH LAWN SPRINKLER SYSTEMMECH EXHAUST - HOOO/OUCTSEACH INSTAL . ALTER REPAIR WATER PIPEVENT FAN SINGLE DUCTEACH GAS SYSTEM 5 0 R MO REBOILER/COMPRESSOR 16 30 HPEACH GAS SYSTEM 1 TO 4 OUTLETSt
((BOILER/COMPRESSOR 3 15 HPfered for sale If however the buIding or improve-H
EACH WATER HEATER AND/OR VENTJ
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BOILER/COMPRESSOR UP TO 3 HPimproves thereon and who does such work ihimself or through his own employees provided 'that such improvements are not intended or of 'm
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NG SEWEROVER 100 000 BTUEACH FIXTURE TRAPINSTALL FURN DUCTS UP TO 100,000 BTU2 s y 5 * a wG'e.s2§5<»=;- 8s"!aS^sJo, S-oS?S^-»oSo> SioJK;«I is
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NUMBER OF STORIESthe Business and Professions Code) orempt therefrom and the basis for the aslons of the Contractor s License Lawcommencinq with Section 7000 of Dw= 5 w o 3|£|||
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1 BLOCKSUBDIVISIONASSESSOR'S PARCEL NO1 1 1 1 1 1 1 1 1 1 1DESIGNERSTATE LICENSEOWNER BUILDER DECLARATIONDl hereby affirm that I am exempt from the Contractor s License Law for the following reason(Sec 7031 5 Business and Professions Code) Anycity or county which requires a permit to construct alter imnrove ripmnlish or renair anvOWNER'S MAILING ADDRESS UU.SW'_J_J«»1255 Cynthia LaneS
CONTRACTOR'S APDRESS ~2501 State St., CarlsbadCONTRACTOR'ST&-3 205:.1
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PRIME CONTRACTORTtfffis PT.TiMmrwa estfRvrmrnTATE LICENSEZ^570?1i^ LICENSED CONTRACTOR S DECLARATION^ 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section7000) of Division 3 of the Business and Professions Code, and my license is in full force and effeetH i
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DATE OF APPLICATIONQ-«5-80BUS LICENSE186Q1^^^-~ m
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"v ^^* CITY OF CARLSBAD-BUILDING DEPARTMENT i^j^B^^ APPLICATIONS. PERMIT ^^ APPLICANT TCUSE BALL POINT PEN ONLY 120Q ELM AVENUE (714)438-5525 MATION WITHIK
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