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06539;ILICANT TO FILL IN INFORMATION WITHIN RED LINES - FY(?FCUPER'CINO BUILDING DIVISION APPLICATION/PERMIT N LN PARK '26539 11- 7-G6 ARG s ✓ A PLANCI IECK PRH GRADING FEE ® O�GBpDING FEE ® q��J0 (/ Y PAID GH BUILDING FEE SEISMIC TEE ELECTRIC FEE PLUMBING THE MECHANICAL IEE TON' 'I'SUCTION 'FAX PAID Date Receipt# J ISSUED BY: UANCE pKZ �i100 �ZW tyir=y F'raZ ZOoe� OZF�p Fy C,�,l s t.l LICENSED CONTRACTOR'S DECLARATION Ihereby affirm thatlam liunsetl underprovisionanfChep¢r9(commencing with Sec,iore(ad).f Divisi.n3Bf the BusimsseM Profusions Code, and myliuveis in I irlarce and cffen Licem�'e�/, la/ys� %Caq[d� hie.# �—d� 38 Z Date ES - RESIDENTIAL MP5 "SIT—Convaca4(JMPS ARCHITECTS DECLARATION under and planggpalL�e,tsedu�bllo nrpc ds, (( �'%--"'� AMPS CTRICAL rnsW Pmfcsaonal b ty d'Q yfol OWNER -BUILDER DECLARATION I hereby affirm that I am exempt fromthe Conractois License Law for the Irwing,.ason.(Secti.n0031.5,Business and Professions Code: Any city or countyL'R which teyuires a Permit ,o coastrvct, alter, improve, demolish, or rtpe'v any tlrvcNinKa.prior to its issuance, also requiresNe applicant frsuchpermitto file a sigmadsm,ememVICESthat he is licensed pmatiom rorhe provisions of the Contractors License Law(Chapter 9(commercial with Section]000)ofDivision 3.f,he Business and Profusions Code) IRCUITIMISC. JER jA OR POLE MST.�; 20 _ -SURFACE Sam O3 -RETURN RM : MF�� c1Ej e 1, ane Q -Mf END M. 2f Toe TREAD, TWO It lom TREADS Q5 -AAU SEAT / BENCH: pt �J