HomeMy WebLinkAbout1774 COTTONWOOD AVE; ; CB891836; PermitDECLARATIONSi£C•ftCi LENDER i£ 3 s r3 - ro l -I hereby affirm that there incy for the performance of this issued (Sec 3097 CIVM Cder s NameQ. s in=r 33.1 1 !III1'ICE TO APPLICANT If afte<emption you should becomipensalion provisions of thfiwith comply with such provicemed revoked« •» « -sg£2SSSf— Q U "0S< 'J oIif|= — *" (D WORKER SCOMF'1 1 1 n CERTIFICATE OF EXEWORKERS COMPENSAlFhis section need not be co15 tor one hundred Oolla1 certify that m the pe'formapermit is issued 1 shall not (ner so as to become subjectDn Laws of California11- *f S3|||ga|i^ g i » ^ o s1 1 1 i "= 5 3 >ENSATION:1V S.M PAN YCopy >s filed with the cityCertified copy >s hereby fui^iS,i?A1 hereby affirm that 1 havn ainsure or a certificate of W<ince 01 a ceM'hed copy thorei.ICY NO"(f\ (0 -,w O £Q q S>' r! -i 1 82 ™ SS -1 o °r pnor lo completion of it3 i have not claimed thlast three years1 am exempt under Secthis reasonP0! -? ^,tO —As a homeowner 1 am imorovmcconditions exist1 Trie work is being perfc2 i nave liverJ m my j!}}* i f1 ^OWNER/BUILDER CONTRACTOR:• 1 1 1plpl-' ?tiai|i|=s.: t'sSlFSslsfl's =5SP^D'£I*liis l?"fl|?=fs iilliil!i!lrg' i^?l- •.H !H> ll'ii!i!'i! JRIsjJlli P*l!!?IIi i;||liflP illWliH l;i!i?!i;!ii fill""ia^si =ifl"-iJa,33 ?-? f5°I ^S J's " o S 5 ^ ttllplf ?lllf||li| =-l>!§l^!?!§I !ll|1 HAVE CAREFULLY FXAMINED THE COMPLETED APPLICATION AND PERMIT AND DCCERTIFY UNDER PENALTY OF PFRJURY THAT ALL INFORMATION HEREON INCt.ULDECLARATIONS ARE TRUE AND CORRECT AND 1 FURTHER CERTIFY AND AGREF IF A rISSUED TO COMPLY WITH ALL CITY COUNIY AND STATE LAWS GOVERNING BUILDSTRUCTION WHETHER SPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVE INOEMfKEEP HARMLESS THE CITY OF CARl SBAD AGAINST ALL LIABILITIES JUDGMENTS CCEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCGRANTING OF THIS PERMITSTSAND AppLICANTS SIGNATURE * OWNER D CONTRACTOR UOF. THE <^SS!? /S° )2^^^^^^^^T)
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i s"Si«ae|n Every permit issued by theBuilCexpire by limitation and becomeby such permit is not commencecif the building or work authoriat any time after the work is coning Official undernulf and void Ifwithtn 180 days fed by such perrimenced for a peprovtstonsof thisnjiidmg or workthe date of suchs suspended orof ISO davs* AN OSHA PERMIT5 0 DEEP AND DESTRUCTURES OVES REQUIRED FOR EXCAVATIONS OVEMOUTION OR CONSTRUCTION OfR 3 STORIES IN HEIGHTX
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