HomeMy WebLinkAbout1710 CATALPA RD; ; 79-5021; Permit/ -•- y^ CONSTRUCTION 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)OF THE GRANTING OF THIS PERMITAPPLICANTS SIGNATURE" OWNER'S CONTRACTOR^AGENT D SYPHONEDTlTlBo
^ 3 CERTIFICATE OF EXEMPTION FROMWORKERS COMPENSATION INSURANCE(This seclion need not be completed if the permit is for one hundred dollars ($100) or less)I certify lhat m the performance of 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 It after making this Certldcate of Exemption you should become subjectto the Workers Compensatton provisions of theLabor Code you must forthwith comply with suchprovisions or Jhjsperm.it shall be deemeciypvokedMJF^ *^>^^ir\ HAVE CAREFULLY EXAMINED THE COMPLETED APHEREBY CERTIFY THAT ACL INFORMATION HEREONFURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUECOUNTY AND STATE LAWS GOVERNING BUILDING CCSPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVELESS THE CITY OF CARLSBAD AGAINST ALL LIABILI^ Z Z 0 S "°rr? Q f/i . L.
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