HomeMy WebLinkAbout2265 CAMINO VIDA ROBLE; ; 80-43; Permit: Q
r -ii
g agency 'g
m
•DCD
formance of the i- *~> °5T hereby aft:irm that there is a construeoD CONSTRUCTION 1.ENDING AGENC^
o
n
ivisionsor1this permitshall be deemed iat
o
a
aorCode, you must forthwith comply w3
o
:rCD
O
ID
OO3T3m
S.o
-oo
5
2,
=•- ^^oiTIC
E TO Acate of ExePPLICANTimption, yo: If. after making tu should becomeUl ^Tc scr
— tJsT ffl
son in anyWorkers' <manner scCompensa1i as to become sulion Laws of Cali1o o-
T CD_. n
Su _certify thaich this pet3 "
»" 3
in' ro
tn T3C ID
•formance of the 'ed, I shall not empa *o of 5-
3
is for onehundred do
IB
^S
o
(D
2
H
CD
53
CDd
33O
l be completed ifCD CERTIFIWORKERSCATE OF !;• COMPENEXEMPTION FROISATION INSURAZZ
m
atia.Cjetuytofon(u
-
«3
c:t/>m
03
TJo2:
H
TDmz
O
8
rD
m z0
COCO1
<-nOlNJ
> "o-H t)
Im r~
L. z•y
~nO
NSPECTION VALIDATE*