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84046 BI11LlMNd Pppq)T-ApPUCA7I17N QSYd�R•B�i^I�D�H DECt eRATON V v'pEpMT A.D- (� SSUED Dv DIRE aWrlw CLMA COUMY aULDING iNFP1AT IO OFF7C6 I notchy alarm artier DdhaRY at PerIUN mol I ern wemmpl ham the I treroby efsm under pendy el Petury that loam under \V{'� Lf .�^61 70 W.FtEDDNGYi.BAfldDtIBCA ss'lio {40a)Zsoaa6t ContractorsUcenm Lswltrthofoltowmpresmn(See.70Ci7-S,Bltaf- Provislats of Cts 9(mmrencln6 6a�an TOoo)of 6M- - O rens cad Profesdone Code:Arty alty or a0"which waquLoe a sEm a of ihe��nrflPr�d swy0rhs driln7 Urenw Is h TaiOLOOY permit b consM4 idler.brnprare.demorollsh. IepNr8lry StnUslure. ,IOBADOR 1uY Intoe an fj. n, Ptsim dBlssuanw.a{al boo reafsifoon apursutlnpathepml K (7EAREDFORISSWNDE EY: /°'�'DA7E dopy of Contracb heorse Le (C haedpuraonsmoraproilh Liw^ee r?e�° �c.1"'- et, 103b ElliAhAF.RLIR•/ Q � donsorf,econtraaylrsl.kenseLew(Chaplerti(oammeAaingwth conuacbr Du. ♦ .c NE1NESfCROBS s]RFk7 a MPECTONREAU Pti10II'oF)NALDISPEOTML Setlbn7Wo)cgDMslon3clih.$csYiemand Poolestlons Code)or �{.SON rat he or she is exempt itwelrom and the bads lcrfte rdeged ax- V qJR .. smpfon.Any rblaemot Sas1011 7031-Eby anyapplicen"Ofe Per > � (�7!/`jt) SOt mlfsub(ecistheapplimmbaelWlPenaYymnolrronrttrmlAsOltao- Il ebllelRrmultQerPenslyefpe ry *tfy armabrailon SET KO(F :FRoxr , �- ' Rr;AR _ dred d7tars(SSOO).): "13I agsrrLy,for the pwetorm of Flak forvArkh Inde per. H 124 i t t O S zS`7'7 g63 m,E ABA Rl O 1.as Owner of the property,or ay dnpleyaes with wages lrU b octroi(sea aD67,C as lhelr9dacomperi®YOILvAIW fteC,,adttre Mtr Lender's Nems: { p /�,,,,, /'� yea Is pot inbrslsd or Clime for sale(Sam 7044.SUM- LatdarsAddenes: CITY 1-Q• fJt"IL. ��3`� �w qua t�-reg 3s c;EARW FOR WA ANC£Dv: Y I1ArQ J ?' --wd Pmfessfaucmq:The c atmOorst�snsOr a Law (tj((QFckTiNO does not apply toasWho do Such mottowRderIno- O 16PFCMDN REOUIRID PRIOR TO FINAL INSPE IL proyeslhdeon,end twho rbea ybh wok hlmxit or trar- seff or ltnnugh his Or her own ea ikoyses.pr-RW that I mrty thud 1 here read*As aMUWon and 042 IMt aw Sbo" 'IN 'Yt lam! 11 l L id J$(f LRNO DbYBOPIABlfT ENa)L a EYINe a rah lmprohe bulla ora rotfitanew rent 15 Oddror s a hle"helton is co" I agree 10 wmply 921 an CRY Mal county 1lAtUNGA how",the twlkling or#rprevarsrwt is Odd w lwln 0rro �/� yearofeompl k%o*o w-huftlarwOhr the burden or nRnms find state laws slatting b ardlmng mrdWctla4 end crrr 03 o G6MM� 1iJ�s✓� �S�Q8 cwAmo FOR Issumt;A B7: Ye ejG of p OYN61ha1 he Or she did not bUUd or Improve IR t e hereby au7gflis RpR9ontalke6 of INS mlRlly in enter upon Uw DP Purpaee of seleJ above++raN"^• nrapady lOninaeetllon purpossnL PBrtiLCA O PAD IMPROVEN 1:3 1,&sownera tlwpropoft emeolushteyoonDactttg wM C o$3 PHO y p 379' 6 O UWYAPPR awru.d rA}I NC1of9 b eon w t he Project(Sia TDM, OtAp plwAnl orPBeoi e Blydrress midProTesstonsCode:Tho CAfArewho uildor O DIHM Low diwsnotappy9oanoeneroiProPey1'w1'o wlWe or ImR�stherom.aaawecoheacZTorrwcQagecawmh • •--.• N Q RISPEC710NRE O ORTORrALPISPECTIOIL aoantnaclar(s)EwatwdperSUmS(Lb 111B•W OralJwrrTa (FDR NON49651110ENT1AL ONLY) n f Law,) Indcsle D Ute hnended oa-PWxy will use lhemerdous maMlals. _ I son camp(under Sea 8.8 P.C. NrlallnB YkaeelaerAedpaatthatli$S Coda S?ctlona2h506.25633. CRY•J O•, q�rpd,y,' w /�,_ OD-P 1m'4ds reason and 25534 ea via as lYera lwgdwecUonFwm+de avelfaDle 10 You- J�(J V ` u-aBBalce .y aiDNE Yes mmmmw,� e pmyr' D,ya LOTRRACT r ' . ARl 3T5—1-7�Qb1rJ Ir WORKPR_^.......�.r�_.eartN DECw�.PArwnv PrnnCItEOkER (:ODE YEAR , P therebya kmurAWpmelyofporluryaneofthebWMngdodos CASFDER'Sl1AUDATiDRS fon: l /vi,iu t•.Wr*ri uuaitiuv< ••t 0 I have and will nrelrrla(n a 0e1111CS10 Of wpR+erd b WP TYPE OFI OVFJ4EM: REf10DF 1E11ViiCNAIlitllALlIEdLTiI' , lltsuretorwadoWe'mNipnnaeOoRas provtmd lerlI r+Rr•InrSn n.tr•+T!rt .. BUI ADO(iION 79(ATUts HEPAR MOVE CONVERT DfjAm1 ".. .. ton 3700 of ora Labor Coda lar the Performance of Ire r i.{i wvcn+w�u10 40 (sora for wlrk]w this pcmtl Is issued e;rr *,1,",- Tt• a^ .wl MEA STORIES awat1Ne Uwe CL FARED FOR ISSUANCE B' F-��-•.i�lr-RP`T .�.LL. u+ . 7,21 d -To --�— � Ilrerewselwllwrabrtalnwoteera'aarylonsaEOlilostRaneo, Ds ?tri :�: y,.i w:w: E UCOON OUIS MMERIAL6 AP rewyared a1r t-7ectlm 3700 of the Labor Cade.Ln the OEM PERS t performance of the workbr%tich this pemdtla lswred. U wxtR SYSTEM P AMY wottaW a�ctrtip,enyymfbnyInsurance cadwr and poltry . O SEPtICBYEIEM pFS16pTY leltllbe[ �lc}l°lr 'v "s S�19S' a:•r#�J�'i''t14'a 1' i1' a m9EerDNrtEoul R DISPEenoN PallcyNnmmr i txR� �yte��-tea ` (TNF section neap rot oY a Isd Y the pe nill 10 for �r� t ,,, a,•k5�1.'i i#36 I p. _ one hundred doGue(3100)or lieu) s IFerfifyIWJOine.pFnomaYtamthe we*Wwhich Ois `p�mYt Is Issued,1 shall net smpiay Ary parson m any CIEAREOFORI 8Y: D -rnannermasto heeomssut>)aoifollvwodCara'a0mpan� COurail'.FILE No. satan mx6 at 0W11WrTs.and ap0.e tine 0 I Should be- t] Uw TO FINN.IMBPEOTION. tome subjedt to the wotmma`sonp0nsairoa pro tis oneaf y� Sadtbn 9700 of 1M Latior Code,l and kdyM h comfy VAYI those protdstons. t =MON App(kyry �rIV FEES �� PtlrneallG S.KLR ISASI FAILURE W SECURE wDpl®IS'CO7UENSATION COVER- ` h 9fPRC ACENIUNLAMFIILAMDSNALLSUBJECTAMELfPLOTEA TO CAAa1AL FIRE MARSHAL r PENALTIES AND CIVIL FINES UP TO ONE RUMORED TIIOUBAND FLAN Cl1E0K PEAID7 DOLLARS(Flm.aeat.IIT ADORION TO THE CCsT Or coaPENSATbN. x OTRR DAYAOE6l5 DED FOR IN BEcIM 77x6 OF THE LADOR CODE. R IIaV.wM OMREST.AND A7TORREY•SF®.