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FACTOR PSF ADJ.AREANALUATIQN � � OWNER•BCILDER DECLARATION - - SFR/ADOIREM - - ' O p 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROIA THE CONTRACTOHS LI- .G8fH90/C2fp01( � W CENSEUWFORTHEFOILOWM�REA50N�5E4Jo71.68U51NE5SANDPROFE5510N5CO0E:ANYCtiYOR (n " U COL'NttYhiIpIREIX1WE5APERMITTOCONSTRUCL�ITER.IM7pOYE,DEMOL15H2ORHEVAIRANY5IRUC• W patiolDedc � ____ W NpE.VRIOR TO RS ISSUANCE.ILSO REOUIHES THE APPLICANT FOR SUCH PENMIT TO FlLE A 51GNE0 W , � STATEMENT THAY HE OH SNE IS 11LENSED PURSUMT TO THE PRONSIONS OF THE CONTRACTORS LI• � CENSE UW(CNADTER 0(COMMENCINO WITN SECTION 7ooal OF�IVISION 70F iHE BUSINE55 AND GRO� � 'PooUSpa fE5510N5CODE)ORIHATHEORSHEISE%EMPTTNEREFROMANDTHEBASISFOR7HEAUEGEDEXEMP• C7 � 7qN.ANYViOLATIONOFSECTION7071.58YANVA7PlJGUfTFOflAPERMITSUBJECTSiHEMPLICANTTO Z Re-Roof � � A CML VENKTY OF NOT MORE THAN FIYE MUNDHED DOIURS(f500).): - • Q 04ASOWNER�FiMEPHOPERTY,ONMYEM7LOVEESWITNWAGESASiHEIii50LECOMPENSATION, � CpmmBfClel Z WILL DO THE WORK AND THE STRUCTURE IS NOT IMENDE�OR OFFERED FOR SALE ISEG.70N,BU51• J NE55 ANO�ROFESS�ONS COOE:THE CONTMCTORS UCENSE UW DOES NOi APPLY TO AN O'NNER OF N VFOPEfiTYNM110BVILDSORIMPROVESTHEREON,ANDWHODOESSUCHWOHKHIIUSELFORHERSEIFOR = ' 2 THROVCHHiSORHEFOWNENPLOYEES,PHOVIDE0iHA75UCHUAPROVEMEN7S�RENOTMTEN�EDOR m 0 OFFEREDFORSALEF,FIOWEVERTMEBVILDINCORIMPROVEMENTISSOLD4liT1nNONEVEAROFCOMPLE- Z TqN.THE ONlNER�6UIL�ER WRL MAVE TME BURDEN OF PROViNO T11AT NE OR SHE DID NOT BUILD OR � IMPROVEFORTMEFURPOSEOFSALE� ' ❑I,AS OWNEROF THE�ROPERTY,AA7 EXClUSNELYCONTMGTINa WITH LICENSED CONTMCTORS � TO CONSTRUCT THE PROJECT(SEC.7011.BUSINESS AND PROFESSIONS WDE THE CONTMCTORS U• VelUetiOff ADJ.AREA W CENSEUWDOESNOTMPLV70AN01NNEROFAPROPEflNWM084RO50RINPROVESTHEREON.AND � NRIOCANTMCTSFOFSUCHPR0.IECTSKITHACdlTMCTOR(S�UCENSEOPURSUAMTTOTHECONTRAG QUANTITY OESCRIP'fION � ' � FEE Y TORS LICENSE UW.�. . ' � O�AM EXEMPT UNDER SEC. B,d F.C.FOR TIIS PEASON , U � - - . .. _ _ . _ . ' _ ¢ u" DATE OYMER V W , ..� _ UCENSED CONTRACTORS DECUIRATION__. _ ' W ' � I HEREBYAFFIRAI UNDER PEN�itt OF PERJURY THAT I AM LICENSED UNDEH PPAVISIONS OFCHAaTEF , � � Y(C01.IUENCINGWRHSECTION7000JOFOM510N70FTHE8USINESSANDPROFES510NSC00E.AND z �� ��� 4/VLICENSEISWFULLFTCE EF CT. � � UCENSE CLAS � �`-� LIC.NO.� � J V DATE � CONTRACTOR a , W . � WORKEFS'COMPENSAT�ON DECLARAT�O a � U � I HEREBY AFFIRM UNOER PEN�LTY OF PERAIRY ONE OF1HE FOLIAW WG DECLA _ N Z Q � _IHAYEMIDWILLMAINTAINACERTIFICATEOFCONSEMTOSELF•INSUREFORWOHKERS' S COMPENSATpN,ASPROYlOEDBY3ECilOt/97ooOFTHEUBOIiCODE.FORTHEPERFORMANCE U � OF THE WONN FOR WMlpl iN15 PERMIT IS ISSUED. _ � 0 w _I HAVE M1D YJILL MNMAM WORKERS'COI.�PENSATION iNSURANCE AS REdUIqED BY 5ECT10N ' Q 37o00FTNElA80RCO0E,FORTHEPERFORAIANCEOFiHEWORKfORMMip1THI5PERMRIS ISSVED.MYWORKERS'COMPENSATIONINSURANCEGARIER/NDPOIICYNUMBERARE: CONSTRUCTION - J � __ �qaEp PUW REVIEW o poucrwuraeER ELECTRIC , 0 (TFCSSECfIONN[mNOTBEN61PlE?mOFTI£PENA�lS(CAONEF1LPDfiEDDOl1Ail5Rl00)OfiLF531 �� /� Z I CERTIiYTI/AT IN THE VERFOHA�MICE OF T/E WORK fOR WHICH T ' LSSl1E0.1 M HAN AL .- ('} SHAIL NOi EMPLOY ANY PERSON W ANY M+WNER S B E SUBJEC O THE � _ ' � WORKERS'GOMPENS�TIONUN50FCALIFOfiN , DAC THAi FIS eEcouE� INSPECTION FEE - S . 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' FIREPLACE BOND BEdM` • -�- ' .'` =•- •.• : �� '- � � ' WATER SERVICE --- - -- - -- - MID HT.��bND'BEAM ' �` � � � `� ``'' __ ,\;\_ `\ ,\ _ ROOF.SHEATHING 8 FT.BOND BEAM ' ' FRAMINGNENTIUATION " FINAL`BOND BEAM- - - - ROOF COVER - - -- -- PRE•GRADING � ' ROUGH HEATING - - - � BENCHING ROUGH ELECTRIC" , -- "-- - - - - -" " ROUGH GRADING ROUGH PLUMBING - - FINISH GRADING ' SHOWEHlTUB TEST I � � � �POOL ELECTRIC EXT.LATH/SIDING i POOL�FENCING WALL INSULATION ; POOL�FINAL � • � CEILING INSULATION OFF SITE IMPS. ' DRYWALL NAILING ' ' DEDICATIONS. SEWER _ _.. _. - - - _ - - FINAL�ENG. SEPTIC TANK = _ _ - ' .-' -- . --. . _ . LANDSCAPEJIRRIG. . ; SEEP PIT/L.L. ____ . _- - ON SITE IMPS. GAS AIR TEST - - -- -- - -- -- • FINAL ZONING FINAL CONST. - -- - -- - - - FIRE DEPT. FINAL � i FINAL HEATING - - -- - ' HEALTH DEPT. FINAL , - FINAL ELECTRIC = . Z�; . ; � " (- DEV.FEES PAID . 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