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"' dl �f .�O .Qc� t � � LICENSEO COPfIRNCTOHS DECLARATION I hereDy Ylirm Nn I�m Ycensed mder qpviams oi Gxpur 8 Icammwauq � with Secnon)000)ol pviewn 3 of Me Businese�nd Prokasiona Cade,md my Mcense n in bl lace and Niect 7C � �f1fi— � � p 3 � W � Q�NNEH-BURDER OECLARATqN:I lierehy�Fhrm 1Aa�1 om mmpl from Hw Camrxmi'i lsen�e law lar IF�Mlowup = reawn�Sec 70315,Bu�iross and Protessians Cade Any nly or eaumy wAch reQuires a permn to tonftruei, Q ,QQ O alte�,�mp�ore demdiah.a 2peir pry Mrieture,pnw to iu nsuence,Yw reQuins Me�pplc�nt lar HeA oermn ►- to hk a sgned�utemem�hat he i�leenud purtwm m Me pwiyons of Ihe Cmtr�cmr'e leene law ICh�pter � 9 Itdnmenunq with Secuon 70001 0l answn 3 M the Businesa pd Proles��oro Code�n ih�t he is�nmpt Merdram � me�he 6as�s im Me dhged e�emption.A�ry vdauon ol Secoon 70�1.5 by�ny�ppl¢an1 10�+prmn Wb�ecn K ��e a0o��c�ne to a�rvA penal[v M mt more than fnn hundied dollas IS500)I� V "' OU � ❑I,�s ow�ei ol Me qapeny,a my wnDloyees wrth wpes n pimr wle CompemaMn,wil do Ae work. � the slru�tun is rol imerded or aflered Iv nk 1�7044.Busm�:s md Prohssn�n Code TM Camamr's lumse q � Law does noi+OOM ro an owner ol Oiocerty who huilde or inproues fhereon,md who dces wdi wort himxN C,) W a Ihro�gh his own amploVees.Drovided tl�at�ueh xnppwmanY we not inqnded m o11�nd Im u4 M.howeun. Z = tM 6udding or impravement ia sdd wiMm me yeat ol tompletwn.Ihe M�ro�•6uiks w91 hwe Me brden ot prwinp a y that ne d�d not Wdd a imp�ove lor Ik Wrpose af n1a.) � �a ❑L u owner ol ihe prapeny.m�xlusrveN mntratfmy wRli�senseA contr�[taa ro consuucl 7M qqect ISa titl 0 7f144.Busines�u�d P�olessans Code The Contrxror'�Liunu law does noe ipply a�n awm�d property who � = hudAs or improues Merean.end who mntrxn 1or wch prope[s wrth�[minetorlsl 6[emeE pxtWnt ro tl�e GmuKla't '_ �=^u�� CONSTRUCTION � ❑i wn emro�uMer Sec. .B 6 YL IAnKh Wrutk�ul PLAN REVIEW � Die °""°' ELECTRI �� VYqiNERS'CON�EENSATIR!DECLARATIUN 1 hereby dfirm thn 1 hrve�urtficm ol crosmt ta tdl�imp�.a ��nro ate ol Wor4n�Compancatien M�uanee,m�tnhfi¢d eopy Nrreol IS�c seoo.��n e.i. PLUMBING QL7tbnfutl capy n hereby tumi�hed � MECHANICAL W ❑Cmtlled copy n filed vnth IM 6uildinp In�pecum ppanment a o.P�.��. Q (3RA� D� � CERTIFIfATE OF E%EMPTION FNOM WORKERS'COMPENSATpN INSUIUNCE This ueron nud m�6e earok�M ISSUAN � N A ihe permn rs lor me Aundred(SI001 a los.I wufy tlwt in 1M1e perkrm�nca al Me work tor v,h�ch Ihit � Spermrt u nsued.l�Aatl mt employ my oerwn in iny m�nrer m�s m Mtome maee��a�Iw M4rkeri Cmqenmum SM IP W+s of Ca y��nis W e o.� �'I-'eZO"4i� nooroei NI/ale�1 E �. �j PARK FEE W AqTILE TO APPIICANT H,�fler rtWkmg�hia Cerolicm ot EmnpWn,pu��oa�wn��r a�.Na�•� �- SCHOOL FEES —�+ Campensanon Provisims ol 1M L�Oor Code.you mwt IaMwiM mnply xnth aeh pwiepna a Ilx�penn@�MeR �+- 6e deemed revoked R*=�r �E;., i�!r.�`,w J � p� dVISIUN Of qIWSfRUU.SAFEiY PERMR I�RT1F1(A71ONiv` i;":.�,.�'� � ❑I MreOy artdy th�t no�xwstpn Me f51 d^��n dpth inro whKh�pnsm u rpmnJ b Jescw�d. �e wdl Ee m�Ee�n emcectim wim Wak�u�wr¢M Oy tl�u�emx�.Md tlut m Wildup Nunue.�cAtald�np,tJsewark. or demdrtion ar Mamantlmp�Mrwl.wdl��Mn`�ry�u(�i¢��Mi� I�V.]2.6rp$.An Y.S�e =�u 341.Tilk 9.CA.C1. �� ^Y � �C; 3 ❑As owirr-6wNa.I wil ro�miDbY�'NM�do woik wMch waYd npnn�N�mn fnm!e 6vi�m d � InAustrul S�lery.n noqd�ho�e.mkss 7ucA pe�wn`hs�yermt b da w[h rork hpm Nt diriaion �s--;, ;. - —., .. . . .., .. �.:,� . .. . . ., , :�� _. . _ �.,..., � ❑�.��my�s.�.ry��wq. .. TOTAL FEES J�' � � casmucrnx�cMuxc ar,��:rl�wnv:m�m a.rbr��-re��Ko�r�aww��+�.A.� 3e e�nr w«Y rn wncn Mo Pumi�u.ure Is.c.wer.w.cl. �'' /� s l�nea's IYme COMMENT�S � ��—�"�~ �� m lendei'�Addrzss • '� CERTIFG7E OF COA�PIWCE MIO MRNdtlZAilUi OF£NTAY.1 arefy 1 Mv�ntl IMit�iCatim rd mr vl IMt IUe nlnm�oon pYen u mntt 1 pd te mnON wNh�/rie Yw�mE eiN��Ytiq m WiM1iq y rmsuuqion.rd�othar¢e i rqwnutne d de Dpaunnt d Biildiiq ad SdeiY lo�Yr�pm W popry . r� I Aaue fir the prynse d mtiiq iuptuMt F IQ� ' y�i +�C a� ��a�` RECPT NO. 1 � PAID BY 1AWDATION ' WHITE—Department Copy,YELLOW—Finance Copy,PINK—Asaessor Copy,OOIDENROD—File Copy,(3REEN--ApplkaMs Copy 'BS106-11l89 , , . : : , �. . 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