HomeMy WebLinkAbout2290 COSMOS CT; ; CB881520; PermitDECLARATIONSLENDER1L 1 hereby altirm that there is a construction lending 1agency for the performance of the work for which this per }mil is issued (Sec 3097 Civil Code) \Lender s Name '|Lender s Address.. .11WORKER'S COMPENSATIONNOTICE TO APPLICANT It after making this Certificate •of Exemption you should Decome subject to the Workers tCompensation provisions ot the Labor Code you mustforthwith comply with such provisions or this permit shall \be deemed revoked 1i1CERTIFICATE OF EXEMPTION FROMWORKERS COMPENSATION INSURANCE !(This section need not be completed it the permit :is for one hundred collars t$lOO) or less); I certify that in the performance of the work for which •:his permit is issued I shall not employ any person m anymanner so as to become subject to the Workers Compen 'sation Laws of California 1POLICY NO " '•_COMPANY . '. Copv is filed with the city! 1 Certified copy is hereby furnished f1OWNER/BUILDER CONTRACTOR= n ?- J" illi"i": PIIIPII*7 IllHillilf! IJJ1DIf i! " -l\ IH?f2 Hsilltll!; IIl!|l!H|iii fifty9I ll i;i;ii§ ti!Ml HIIisfilN 2s §s Ii! I WJS1! !?!f!i P?sii s IM i ipi IRIi ill ilii tillif. . Ml! Ijlf liilQ-j" ° n w * ^i^^S ^-^ 3reroo.|SSmSra § §-^ ^oi^--oocS(J,o 5»55ISTRUCTION WHETHER SPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVE INDEMhKEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS CCEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCEGRANTING OF THIS PERMITII HAVE CAHEFULLY EXAMINED THE COMPLETEDCERTIFY UNDER PENALTY OF PERJURY THAT ADECLARATIONS ARE TRUE AND CORRECT AND 1 FISSUED TO COMPLY WITH ALL CITY COUNTY ANC X ! 0Cn — < "OH .T ZC> m -n oTIO
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DEVELOPMENTAL
SERVICES
D Assistant City Manager
(714)4385596
YY'LJ Building Department
D Engineering Department
D Housing & Redevelopment Department
(714)4385611
D Planning Department
2075 Las Palmas Dr
CARLSBAD, CALIFORNIA 92008
(619) 438-1161
Citp of Cartebab
SUBJECT TESTING ELECTRIC METER ON PERMANENT BASE
CLEARANCE OF THE METER LOCATED AT ^L ^ Q o Co 5
2AC^US>&A^k \ Ok* IS FOR TESTING PURPOSES ONLY.
THIS DEPARTMENT RESERVES THE RIGHT TO REMOVE THE METER AT ANY TIME IF
THE REQUIREMENTS OF ALL DEPARTMENTS ARE NOT COMPLIED WITH EITHER DURING
CONSTRUCTION OR AT THE TIME THE PROJECT IS COMPLETED.
PLEASE RETURN THIS STATEMENT WITH YOUR SIGNATURE TO THIS DEPARTMENT
THE METER WILL THEN BE CLEARED THROUGH THE SAN DIEGO GAS AND ELECTRIC
COMPANY.
THANK YOU FOR YOUR COOPERATION.
MARTIN ORENYA!
BUILDING OFFICIAL
APPLICANT.
DATE
0