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UCENSED COHfRRCTOXS DECLAFATION: I hereby ellim uMx penely of pw
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EN BUILDEfl DECLANATION: I hereby affirm under pendy d perN�Y �� �� aTemq ���� �a �ev.' �a IM
owvg reeaon (Setlion ]031.5 Bus'vwsa eM Pmtesvima Cade: Any cRy a couMy whiM 2qui e peimn io c«uwn, ener, impove, FA1t1C 1 Nli it t.� ; P tl V V; !'AttC. t. L; 4 L b L y.i U y L IV G: t( t t TIV ;
md'sh. or repei eny eVucluro, priv io im'ss�aM:e, ebo requiroe Ihe eppliram tm euch permn to fib a eipned �tetemenl ihel he a eM kr La�N 1 tVl� N V T r. �J %
licenaed W9uent lo iM provieione d iha Conirecton limnae lew �Cheqx B(mmmmarp xilh Sedion ]OW) d Oveion � d ihe
usiness antl Profeeaione Cede� or ihet he a ehe ie examq Iherehom eM Ihe bmia lor the elbped exemption. My videtion d Sepnn i
)031 5 en iranl la e rmd auqeds ihe Icen� lo e anl .. . .. .. .. .. .. . . .. . . . . .. - .
� N' ravW' 0a ePO� ceNMdnotmomiheniHehunereEEollenl`�11. nitxxxxx�ieii�iiii��fieieiei'riisiiFiFiFieiciiieiei2ifiii�xir'veieitit'v4i'vitiFieii��rtiFifi't�icicii�iiif'vi#+bii�ieieiei'ieitiFieiFieieififi'titieiri'ti'riiieieif+fi'
� I, es owrrer d IM propany w my empbyeav xih wepea m ihe'r wb compenaalion, will Eo IM woA, enC iM nruclure u nd inteMeE ll t�T Y. L V Y�'i Y� N 7 S E ft�'V I l; Y, 5 tt Y, j„J U j jt Y, i+� E fV r 5
«ollared la eela (Section )OM. Buzmss eM PMenaionaCoEe: The Comreaon lirenae Lew doee ml rodY loen ownerd qoparry
who buiM a inpmrea 1lwraon, end who doea autli waM IimwX a MneL a ihruph he a hm own employaas, qrnked thet euc� �
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Profesvme Code: Tha Comrmon liceme law Cws iwl epply io en owis d propeny xho Wilds a impwm ihaean anE who
cam�ects M auN pqeas wilh a wmreaar(e) Icaruad punueni lo IM Contretlan liceiue lew�. • •
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IamaremquMxSeciion: 8.8P.C..t«ihiaroeaon: A!'!'L1LAIIVN 1SSUtL HY; ' ' ll�:lt.•
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essaa. ene mm I a eny INura buildino �vem will / wil rwi (rirck me) naed �o comdv dh eeid etme codec e�M iM reQuiremems br Li LLl'� YM 1 r L UMFs I NG �L Y.l. 1 t( I l. M Y,C. HE11V 1l, Y l lt Y. S M I Y% t( �:.i C.�t(AlJ 1 NG
parmn lorconniuctmn w moEifiralbnhan�haA'v�OZe ty�'erepement Dielrkl. FesiAential m�Mrud'an epDY'ratiaroaraeramptrom Naw
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Deta: ApplicerJ:
W OHKEN'S COYPFN4�TON OKIAP�TION: I Meby elfi�m under panMy d pejuy ma d IM /dbrrinp EerWet've:
� I heva eM wil meiMen a cMXkAe d m�wnt io vaqiiuwa b r.orken comperaetion, n prwiEeE la by Swrim 3)00 d tM lebor
CaAe. ta Ihe peAwwics ot Ne xwk la wMJi the pe�mn u ueued.
[] � neve eiw wi� meime'vi �.onen' mnre�mun Irmn.m.... r.a�hee W sealon aroo d me teno, cod.. t« �ne wnwmenm a �n.
� wpk lor which ihi� pe�mX ia iaeueE. MY waken' mmpenulbn insurance cemer and pdiry number va:
cemer: IALlY l;V%'fY t1iYl7(t.5
, Policy Number: lv � b L/ 125 V 1% V 1% 7 t�
(m;s seaion need iwt ee comWMea � ma v�Aia ro. are n�ndied ewws B�al a kav.)
❑ I milily ihel in IM perloimence d tM1e wwk for v.h'rh thu Po�� �e �eueE. I Mell iwl emply� erry pe�mn in eiry menner ao m to
bacmie wbjea to tM vrorken' campanaelion lexa ot Cel . eM epree thel i� I ehouk Eacome eWp to �M wike�e'
�mpe aeiio mvieu 1 'on 3]OD W tM lebar COAe. I I! Pmmp thoae pw'vime.
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lnp: Fallun b ueun worteri ro�owetlon eav unlawNl, aneiMl/ ub player fo eNMrol psntll/s� aM
lI flnu up ro ons huM� Mous�rd doll�n (S1PqOWA M Ms/fbn b tlts coaf ol eo WR Carrrpu u pror/d�! br In
Sxtlon 9]P6 0l fhe Le6or Cods, Intwu4 � effomsY'� less.
CONSTRUCTION LENDINO pOENCY: I hereby etF�m uMer penehy d perjury thm then u e mnnrvebn b�Mirp epe�wy for Me
paAamema W �M1e wwk br which thb permi ie esued (Sed'on 309), Civ. C).
LENDEfl'S NAME:
LENDEX'S 100RE55:
I ceMiry ihet I hera read �hie applceiim and mete ihel �he ebove iMormetion ie mme. I epree to comply xnh ell dly eM couny ardinencee
arM slate bwe mle�i�p to Wildvp crostruqion eM haraby eulharae rapeeenlelivm d ihis tilyto enlm upon IM abo.�e-manlbnetl paperly
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(5151d6.WP) Whne-Buikviy� Selery: Greeo-Fle; Cbpq�qpp!irenl; Rnk-Revenue; OddeniuLMeevaor
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I1-03-1997/09:24 Atl/535.25
RCRTH:61-801A846
PEkMIT:@85554
CONSTFiUCTION AND P4ANNING
�` POO SPA
APPROVAlS Permit # '�l Date Inspector AppROVALS Permit # ' Date Inspector '
7, Temporary Electrical Service or Pole 52. Pool & Equipment Location ��
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilitY�Undrgrnd: 54. Forms
4. Electrical Conduit-Undrgrnd. . 55. Elearical Bonding ' �
.5. Steei Reinforcement � 56. Rough Plumbing & Pressure 7est � �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
.
7. Footings 58. Electrical Conduit-Undrgmd. �
B. Foundation ' 59. Gas Pipe, O Undrgrnd., TesT �
�
9. Water Pipe-Undrgrnd. 60. Backwash �ines, P-Trap, O Undrgrnd. -
10. Structural Floor SYstem 61. APPROVAL TQ DECK '
71. Property Sewer Line & House Connection � 62. Backwash & Receptor-FinaP�. �
12. Sewer Cap � 63. Heatet & Vent-Final
13. Roof Orains 64. Plum6ing System - Final . -
14. Rough Plumbfng 65. Electrical-Final
15. Rough Electricai-Conduit _ - . 66. Solar SYstem-Final .
16. Rough Electric Wiring , 67�. Pencing & Access Approval ,
17. Rough Wiring Sign - � � � 68. APPROVED FOR PLASTERING .
18. RoughElectrical�T�BarCeiling ' 69. POOVSPASYSYEMSFINAL '� �
19. Rough Heacing & Air Conditioning ��� �- � FIRE DEPT. REQUIREMENT
20. Aou9h Factory Fireplace � - ' ,' '' ' APPROVAUS'.: Permit # �
27. Ducts, in Structure �� •� � - � � 70. Undergro�nd Hydro �
22. DuMs, Ventilacing � .. :_ �,� 71. Product�Piping�eJGas OOiI
23. Gas Pipe-Rough & Test � • �. � � � � 72, Undergrbund Flu"sh � �
24. Roof: Fra-ming• " " - '�: t-, 73. Undergrpd. Storage Tank C] Gas ❑�Dii
25. Roof Sheathing � �� � , 74. Overhead Hydro
26. �T-Bar Ceiling (Struaural) & Monocoac . ' � ` 75. Dry Chemical . ,
27. ,Frame and Flashing� - , - 76. Dry Standpipe� ,
28. Lathing & Siding - , � ' � "i.. 7�.. FIXED�SYSTEM.FINAL -
� 29. Insulation � . �- � • 78, FIRE PREV. FINAL ' . -
' 30. Drywall Nailing • ' '' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat , i� 79. FINA� INSPECT}ON ' -
32. Electrical Power Meter�Finai ' � ; i' 80: FOOD CERTIFICATE ISSUED, .
..
33. Pina(Electric �� �� Notes: � � ' r
34. �Pinai Heating & Air Conditioning . _, /_� � � � .. � � ' -
y � ,
35. Final Gas Pipe.�Test ,` � . , , ' '�i ` � , � � �
36. Hood or Canopy � � � � , '� _ � ' ��
37. �Final Factory Firep4ace - . ' t I � ' ' . - . -
i:
38. Final Plumbing � - 1 ;� j� _ � � <
39. WaterService�Final' ' ' , -�.�; ' �
40. Gas Service�Final . . � , � . �
;.
- 41. Solar pomestic-Final - , ' ' ; '
��
42. Backflow Preventer : .
�
--43. Backflow Irrigation ' ' ' � '.
44. Landscape Irrigation System- _ . , . • �
�45. �Sound Attenuatiorr ' ' . ' - ` • '
� .
46. Fiandicap Regulations � ' ' • i � �
A7. FfNAL STFUCTURE & BUVLDING • • -
48. FINALPLANNING; � . �� ',r• � �� •
49. Eleccric Reiease to Edison �; - -
Sa. Gas Release to Southern Galifornia Gas Co - � i .. �� .
- .
51�. CERTIFICA7E pF OCCUPANCY -.
No. Date