Section 4858 - Application for Design Approval Agency and/or Quality Assurance Agency Approval(a) An applicant for approval to perform as a Design Approval Agency and/or Quality Assurance Agency pursuant to this article shall make application to the department using HCD-MH 470 Application for Design Approval Agency and/or Quality Assurance Agency Approval, dated May 1989 and provided by the department. The applicant shall provide the following information:(1) Indication of whether the application is for an original approval, approval renewal or supplemental approval of a Design Approval Agency and/or Quality Assurance Agency.(2) The firm and corporate name, business and mailing address and telephone number(s) of the applicant.(3) Indication of whether the ownership structure is composed of either an individual, partnership or corporation.(4) The name and title of the individual owner, or the names and titles of all partners, or the names and titles of all officers, directors and major stockholders within the corporation.(5) Identification of any individual owner, partner(s), officer(s), director(s) and major stockholder(s) who will participate in the management or supervision of activities pursuant to this article.(6) On a separate attachment entitled, "Organization," the following information as applicable: (A) In descending order of responsibility, the names, titles and responsibilities of all directors, supervisors, managers, architects, engineers, technical staff, Insignia Administrator and Quality Assurance Inspectors within the organization who are responsible for the activities to be performed pursuant to this article. An organization chart may be attached, if appropriate.(B) For Design Approval Agency applicants, the name(s) and California license number(s) of the architect(s) or the California registration number(s) of the engineer(s) who will perform the inspection of plans for structural systems of mobile homes or commercial coaches as specified in Section 4852(b).(C) For Quality Assurance Agency applicants, the name(s) and department approval number(s) of each Quality Assurance Inspector who will perform inspections and monitoring activities as specified in Section 4854(b).(7) On a separate attachment entitled, "Qualifications," a detailed explanation of the applicant's business activities and how the applicant meets the requirements of Section(s) 4852(a), (c), (d) and (e) and/or 4854(a), (b), (c) and (d).(8) Attached resumes detailing the education, training and experience for directors, supervisors, managers, engineers, architects, technical staff, Insignia Administrator and Quality Assurance Inspectors who have not been approved by the department.(9) For Quality Assurance Agency applicants, on a separate attachment entitled, "Insignia Administration and Security Procedures," a detailed explanation of the procedures to carry out insignia administration and security procedures as required in Section 4882.(10) The typed or printed name and signature of the individual owner or the typed or printed name and signature of all partners or the typed or printed name and signature of all major stockholders, officers and directors, and the typed or printed name and signature of all managers, supervisors, architects, technical staff, engineers, Insignia Administrator and Quality Assurance Inspectors on form HCD-MH 471, Absence of Conflict of Interest Statement, dated May 1989, and provided by the department, certifying under penalty of perjury to the absence of any conflict of interest, potential for a conflict of interest, or any collusive or fraudulent practices as specified in Section 4872. The individual owner or the partners or the major stockholders, officers and directors and the managers, supervisors, architects, technical staff, engineers, Insignia Administrator and Quality Assurance Inspectors shall also include the date, county and state that certification was executed.(11) The signature and typed or printed name of the highest ranking officer of the ownership certifying under penalty of perjury to the accuracy of the information provided.(12) The date, county and state that certification was executed.(b) If additional space is required to list all partners, officers, directors and major stockholders in an ownership structure, and identification if they will participate in the management or supervision of activities pursuant to this article, the applicant shall indicate that such a list is attached to form HCD-MH 470 Application for Design Approval Agency and/or Quality Assurance Agency Approval, dated May 1989 and provided by the department.(c) Form HCD-MH 471 Absence of Conflict of Interest Statement, dated May 1989 shall be attached to form HCD-MH 470 Application for Design Approval Agency and/or Quality Assurance Agency Approval, dated May 1989.(d) The applicant shall present other documentation necessary to determine the applicant's eligibility to receive public benefits pursuant to chapter 5.5 of this division, beginning with section 5802.(e) The application shall be accompanied by the fee specified in Section 4884(a) and/or 4884(b) for an Application for Design Approval Agency and/or Quality Assurance Agency Approval.Cal. Code Regs. Tit. 25, § 4858
1. New Section filed 10-6-88 as an emergency; operative 10-6-88 (Register 88, No. 42). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-3-89.
2. The Certificate of Compliance transmitted to OAL 1-31-89 was disapproved. Order of Repeal of 10-6-88 emergency order filed 3-2-89 by OAL pursuant to Government Code Section 11349.6 (Register 89, No. 11).
3. New section filed 3-3-89 as an emergency; operative 3-3-89 (Register 89, No. 11). A Certificate of Compliance must be transmitted to OAL within 120 days, by 7-3-89, or emergency language will be repealed.
4. Certificate of Compliance including amendment transmitted to OAL 6-29-89 and filed 7-24-89 (Register 89, No. 32).
5. New subsection (d), subsection relettering and amendment of NOTE filed 3-20-98 as an emergency; operative 4-6-98 (Register 98, No. 12). A Certificate of Compliance must be transmitted to OAL by 8-4-98 or emergency language will be repealed by operation of law on the following day.
6. New subsection (d), subsection relettering, and amendment of NOTE refiled 8-4-98 as an emergency, including amendment of subsection (a)(7); operative 8-4-98 (Register 98, No. 32). A Certificate of Compliance must be transmitted to OAL by 12-2-98 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 8-4-98 order, including amendment of subsection (d), transmitted to OAL 12-1-98 and filed 1-14-99 (Register 99, No. 3). Note: Authority cited: Section 18020, Health and Safety Code. Reference: 8 U.S.C. Sections 1621, 1641 and 1642; and Sections 18013.2, 18020 and 18031, Health and Safety Code.
1. New Section filed 10-6-88 as an emergency; operative 10-6-88 (Register 88, No. 42). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-3-89.
2. The Certificate of Compliance transmitted to OAL 1-31-89 was disapproved. Order of Repeal of 10-6-88 emergency order filed 3-2-89 by OAL pursuant to Government Code Section 11349.6 (Register 89, No. 11).
3. New section filed 3-3-89 as an emergency; operative 3-3-89 (Register 89, No. 11). A Certificate of Compliance must be transmitted to OAL within 120 days, by 7-3-89, or emergency language will be repealed.
4. Certificate of Compliance including amendment transmitted to OAL 6-29-89 and filed 7-24-89 (Register 89, No. 32).
5. New subsection (d), subsection relettering and amendment of Note filed 3-20-98 as an emergency; operative 4-6-98 (Register 98, No. 12). A Certificate of Compliance must be transmitted to OAL by 8-4-98 or emergency language will be repealed by operation of law on the following day.
6. New subsection (d), subsection relettering, and amendment of Note refiled 8-4-98 as an emergency, including amendment of subsection (a)(7); operative 8-4-98 (Register 98, No. 32). A Certificate of Compliance must be transmitted to OAL by 12-2-98 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 8-4-98 order, including amendment of subsection (d), transmitted to OAL 12-1-98 and filed 1-14-99 (Register 99, No. 3).