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COMMUNITY DEVELOPMENT DEPARTMENT
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� 1 HEREBV AFFIPM 11N0ER PENALTV OF PERJURV THAT I AM LICENSCD UN�ER PfiOVI510N5 OF CHAPTER � '
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p DATE: APPLICANT: SN1�P � �
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FOR TNE PERFORMANCE OF THE WORK FOF WHICN 7HI5 PERMIT I5155UE��SEC.3097.CIY.CJ.
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w 1 CEHTIFY THAT I HAVE NEAD THIS APPLICATI�N pND STATE THATTHE ABOYE INFORMATION IS COFRECT. TOTA L FE ES a zzs-,�3 � � !�r7� �`+
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