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HomeMy WebLinkAbout1284A (6) \VOk,(C[LS Cf1�PFV$A'T'IOt�nLCLA2AifON .. . . . . 76R364G � � A �rCjp pr`,q � ��q50g �/°��,�C�gQ�s�i� � I hereby �tf m t a[ i hava u c�tti� t� o�. consent [o setf ��E��878(2-80i, P�i'i-L 9\�,.d'$, O,;d�� 4d . iG f�0�b 5 �nsu:e.or a cer f�� t �f��4orkers Comyeu;at�oa lr.surancx,o} - ¢-{���'�"[��•i.j£,'jy'f'EB_��rkiy�-/,y1R i".,.L#ft��6Tl�P+iFR$^�'e.a . . a certif:e3 capy.h:reoF(Sec.3800.(ab:�(,.j P�,��,;r�o. 306–&2..�,r�,,,m�Gtate Comp. ins. Pund I I �� Certi�ed co�y i;t r b. turnisne6 ' — _ S�NCELES . BUVt.D{AiG AND SA�ETY FOR�P�CAN P p�i�,�n�����Tract,35742 Lot 38 r—, ,.�-�- .�.:,,. �A.,�._ . � Certif�ed ceipy vs t�Izd with tFe cou'�1y buJdanE inspectian � �� -��"� �. � gUl INGx� � deva�tmen:. ��� aooacss 20b6 Lake Cen on �___,. Sumr^it Sheet MeY2J. Cr,. �aR o o y — -- r�ar<<$(]�6L8�:��:,�r,t._�.— _ .. . � ��' ��— �OCFlLITy � rz. . . ' !VO - !TYPE C)F�APPLiANCE OR EOUIi'NiENT j GEE .. . . -... ... CGR'CI1'7C A7c;.OF 1��XF'�t'r'PIOV�I'R01t 4VO..Kf:RS' � ` - � ���� � ������� �:C31tPFNS?.TiO\IMSu1t.4:YCF � � ��"— � �� - ������ � � � M1M1EAREST � } .. � � -CROS55L �, _. . C (7hrs seci�m nzcd r.ot be cnmp�et�u if fle worH FnvnlvEd Iq��SOF!�7�O�UNiT,o:�u�_,���� . . _.� ... . by' tihe pet'mit is Cor: une hur�de� dcl7s-s ($?O�J)or�.ess.} . � - - � � as.r+;cr rvo.���'�T���� �aa,oce;seo ev�� I� � 1 ecr�i4'y tt 3t m the performane.oF Yn wo k or uicn xhis � �'AiF HANC�CIN UNIT_CF0.7 __ � �1 � pernn is�s ued,1 sl-�all np!empt>t a iy p�tson n arty mnnner � �' ... . . . 1 .. p-�/ � .. . � Q �o as to bewme xuhjec[u�ihe Nurkers .:.oinpansatinn Laws. ;B�ILER.67U ___ ;� ��;� `�� � .. . ` r- � ��� 1- � — _.� � -�`—r . •� �f� . . � � � � � . � I . . .4aFROVF,IS�.. OATE �I . ,�o:�ssi�rvnluaE W Uatc ' � A?` ant _ .... ._ ... ���CCL1PRESSGR RTU F.. .�FfiOI�.'i. .. :" �/ ��� .j p� .r------_-- '__-- �y�. � VOT C�...TO 4VPi ICAi� If aii r �k .g tl3 C. t ficnt of. !'�J=NTILATICN 51 S EM �... .:. ' -�—'-- � �� -�� ---J..y Z 1. emption you Ii u J iec<re �su.je:t tr ria t✓or4e s' �1� '_ . .� ��7' `�}� F'�'4� /�-� t� _ C�v pen.s�nor p ntc.n nf t iu I abor(.c de ou mu:t fo.h-. - I .. .;��— . . . . ... . . .. with��ian^.pp• wieh such Proti:�rr.n� a: [his EVnPORATIv_Cbo�eR . . . , UA�IDA'!Ch � germrt yhati ue ^« . .. _.. : .:.. . , ��` 1 ' �.'t-'__ . . . . dee��e�l re,�o1.td � ��� . , . . � . 1.-Cfi<SL�)COVTR��.C;TORStJF(:LAR4TIC'h' .... IFIGOR._ E+TU. _^,I .. . . . . .. IFUFlNACE: AU --.�G:iA�/i7Y_._...„._ ;htreb}�aff�crm thst I.�m��censed uad8r oro ,vo�,s nf Cf apCer ',yEATER�. SU.. f_�.DED .. IJMIT �T� � .. . � 9 (commen mg with n� r r�-04Q)oi .ivi n_3 nf thz B«ni- ' � � . WA�i � � � � � , ::e;y and i'>fess�ons Cod and m� hcense��re� f il.farce irtd - � � � � � . . . � � �- �`frct � . . ��,�.� .. . �cense�u,nnec 1�5432 �c t.,acs:_C.�`?�__ . 'i � � 8/16/83 !` --�— — ---- � �-- 3��r Su.mmit s1� r acr A_ �� i u : am >zempt from �e�licensinp,re4u r m�nt s!xm x �` -_. .-.. .. � %� ��:I� �` @icensed arChi<ect .�a regittered prut�ss.on..] engi»cer {��yn Ch¢Ck fP8 2J°�Of 3aQVE. � '. � � � � � � .�ciit�6 m my p�fps�c� I crpaci4y :Sec:ion 9051, &us- -=— � -- �� .. � . . �� �,'.s-o�e e R �neas�nc.lrofes.i..nsCodrj. � � PET'r49ST{SSL3�G`FF_E S�l 1� .�() , �.--�:--� � J e x 3(1 S 0 Lic.or Rre.ito Ua . TOY6tL FE5 I !y'S� ...�_�.—._�_.�C � -r -�.a i[ORfF CWhFR f3 J3I I)FR DECI 4t2P ION � � � � , A °�J 4.:v o .. Pi_AN C}iECi<APPL�CAl�f . . i herrryy .�fttrm I'd[ t m ex -rlpt f.tim the Coni nctor'5 NAME C�m]C SI12P.t T2t3.1 CO.�`IT1.C. �£� C�.g'� L�cer,se I.� .ur[h� fuil<�w!ng�-a.oa(aertior+ �037.o Busi- . . . .. . necsanaPo�sS�rmtC�cle� ADDPESS Z1�1.1 Delsha.re .St. - . ... . � . _ ,�.,, � I, at vner bf Ne p-uperty ��.iil do 4nc:wurk ae A thc � . . >truc z �s not i„cen�lecl or of�fered for sala.{Section �L�TY`T'aF7£.l].3P Ci9Ta@tl$ 'E-'�N�' Jr2.7'-�� . �- . �=--="� - � 7044,Busln�ss and Profesvo�x Ccde). ,�.- . . . OWfJF.R � �,j. ]�rOC�.0 � SOIl$� II1C. a I,as owner of the ,nroPer[1 �m�zc,us�ety .:cen'raetmg . __ -.._. ___ �. � . . �+�th licenr,tict cor.[-actors t� �on tr�t Yhe pru�ecl MAIL � j a . . � 1se«�o��oa�,a�s�n��s��»a x���:�ss�o��.t�<>ae�. nonPess__'1698 Greenbriar T.zne, 6224 � , cotisr::�cru�N'r,L�niti< ac r�vcY c,rv Brea re� �vo. 529--b17G : 1 hcrcLv a.°.'mm thn t'+ere is a cc�st u � -`--` ` -� ��� .: .. ��� . .�o c �1,ng ge C?• �- �u tle�perfe�rmance os =n� .�o�!: so� w�,� i, tn�s aerm�t ,s C�NTRFCTOR Sumc�it Sheet Riet�l Co., In� sued(Sec 309�,Civ (.). -- . -- �----- . - --?� . .. . � 21511 Belshire St. ° • L�nde.'s r2ame . faDt3aE55 ,,.�.,____,_�.: . . . � � ,' , .. � . L dei's�ddreas_._--_. . . _ . . , —�— ..,. ,._.,. .,.4�, ^ � --" �'T� Yacaaiian Garde.ns � ""_527�5863 ,_� 1 �c�n;Y that I have iena �his apP,i�ariern ard state that the STATE�... Z9S(�32 � 'C �-1},� � . abu�e inF�irm�[ion i.�corraci i ag�ee to cnmr�lr��vi,ti al:County IICENSE�i0. . . . .. . CLAS5 . � . .._ . . .. ordinnrtces ana Sr�t la�n:.�re�u�at;ng Heann�,Ventilatin:;and . . . . . . �.��,.,�,osP-.....,.:.>,,.��-,.:�-:,�..-.��-:�-_;r. . ,�v Cond fi n n�.end her�b���auT�ho ze r,pres n t�cs uf th+.s � ;iL:t..Itl.�'SRSE.'O.{F'XYI,ANA?'OR�Y L.A'ilGUP:GF � � Cnunty u enter t i �.ic xb��e nentiun�3 prdge t}'�tor � ri Uecno�pu u. . , . . . ..._. _ _.. . . . . .. .... . . . , }��� 8/16/83 , ��{-�,�_�.�.�-��� .�@natur r�l E mi.i�c i>ztu _ . . . .... . . .. , .. Y iNSP�'eCT6�'c Ni3T'cS -.V_.__.__..._-.e. __..'----.------..-_._..---._---�_.�� ..__. 1�Y;19��PiC-33i1IL��iZ iit:':i.t3a`L.ea['�3"a w_.___..__.�_______._____--- ----------�_____. . � .� i�e,eba�:atir.-,n�t:�st t an:eaempt;'rum E;:?.i.ontsactDi s ..._�__.__.�.._._�.w._._�._._..�_.�....__.___�.__,.,__...._.�_,._.�_... ;,�censc Le.� fcr :i:e f�7iew::��xeast,3t/Secr:'�an 7631..5, . . . � . .. , � . 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