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7.50
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6.00
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6.60
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6.00
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if Ing010"'16922 take Fr011
Ttact Lot No.
No,
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Address « .2 p j t3Jve Rti
tel.� ko.(714)
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Addf0sS V ------ -
Tei No.(714) 97k;
City Aiililleillls
City
Si"I Lit. NoAO0192'�-.
LIC. No, 17 4 693 — ------
A C S L d d C Y
e N
U U
se of I'lollding
Nev'�
Old BuIldin9'
bo
FEE ------ --------- jkr� all
,,qmts application and agree1t) CO"'Oly 40� 11��4'
(ea �ulldlnq c0nslluc"On' citN of
hav114 itered and required by the
141t wS 300*Cbble to 1 licensed as re
t. 1 31-11 VI"Gly "911 ate Of Callf0fill2o'Or
Hu'rmi%jr�;-on Beath and the 51
431 0"'inef Of the above
I 3m the le tj 1. A Cettiocite C� —O �ne q1ty of HUntit"it,? lid by the
I have file consent to sell-lpsttte IlSu
{jireCtOf
st'ial R'-�latlon$ or
Z. of InOu ti-'3te of WO01; Ss Conjilensalibn Insurance lssuecA by
A cell" ce tillp -
an acIM"Ied insurer, t)0pfjjj: -ile WefeOf I tj by tht
or d
An exact CODY lCrw thi5
Of tilt ;r'sArer, Of, lance Of 1110to( %N11 �
certf) jj-�jt,ln the peifOrn manner
I shalt not cml$lloy any ilef son in any I
permit �s issued, ',ut- -ect to tIlt, wor ke(S c(I"lliensatic-in 13-6 Of
50 as 1z t�tCorne s I
the state of C11001013—
that tile 10Tjoing is
I ce Ify Or --eclae) under penalty 0( 00f,'""
declaration %VaS e)(OLdle'd on tile
an d California
-otre:t' H nil [3cacilt
0 9
it %.jjDrk is, not COVAIntnteit days from.' date of issue of "(fits
of it s�Otk is tied tot nj6j6� than 180 day$- this P�b�rrlllt
ip@ttitit
III be' Ault a,id v6ld
'A00roved bY
e "w
ApiltaYeiS Date
ROU911
issued by FINAL CIE
Rett I P
Inspector ._