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� ICITY OF DIAMOND BAx i-� + �
'��" DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES r''� � '
21660 E.Copley Drive 5uitc 190
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� I HEREBY AFFIfl►1 UNDEF DENALTY OF PEHJURY THAT I AM EXEAIPT FROA1 iHF CONTRACTORS L6 GBf�ge/CalpO1S i3
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�L IURE,PRIOR TO ITS ISSUANCE,AL50 REQUIFlES THE APPLICANT FOR SUCH PF:fiMIT TO FILE A 516NED w �����
� STATEMENT THAT HE OR SHE IS LJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LL ����
CENSE LAW(CHAPTER 9(COMMENCINC WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS ANO PRO� � POOUSpB
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Y/ILL DO THE WORK,AND THE STflUCTURF:IS NOY IMEN�ED OR OFFERED FOq SALE(SEC.7046.0U51� J
NE33 AN�pROFESSIONS WDE�iME CONTfiACTORS LI�NSE LAW DOES NOT APPIY 1'O AN OWNER OF
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Z TION.THE OWNER�BUILDER WILL HAVE 7HE BUqOEN OF PqoVIYG YHAT HE OR SHE OID NOT 8lll!D OR
� IMPROVE FOP h1E PURPOSE OF SALEJ.
LI I,AS OWNFROFTHE AHOPERfY,AM E%CLtJ31VELY CONTRACTIN�WITH UCENSED CONTRACTORS
� ¢ TO CONSTRUCT THE PHQIECT(8EC.1ou,BUSINESS AND PROFESSIONS CODE�.THE CONTPACTORS LI� V81U8t1011 _._.__.,_ ADJ.AREA__
W CENSELAWDOESNOTAPPLYTOANOWNEROFAPFOPERTYWHOBl11LDSORIMPROVESTHEHEON,AND
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� 1HEHFBYAFFlRMUNDERPENALTYOFPERJURVTHATIAIALICFNSEOUNDERPROVISIONSOFCHAPTER �
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�THE WORK FOfl WHIGM Tl515 PERMIT IS ISSUED. �
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- __1 HAVEAND WILL MAINTAIN WORKERS'WMP[NSF710N INSUFANCE.ASp WHICH THIS PERMIT IS �- '
> 37o00F TH�R CODE,FORTHE PEHFORMl.�CE OF THE WORK FO`ICY NUM6ER ARF� CONSTRUCTION .,__ � ��
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� WORKERS'COMPENSATIONLAWSOFCALIFORNIqAN�AGREETHA �FISHWLDB E iNSPEC710NFEE _ __ ._
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� SECTION3108OFTHEIABORCO�L-,INTEHE5T,lWDATTORNEY'SFEES. RETENTIONFEE: �
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