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HomeMy WebLinkAbout021-060-009.09 2785:918'-` BAR TSbH CHI. Paul '.& Irene o X1537 Block, Gridleyx` ' ;, Y' AZEVEDO, Alvaro M.r_._ r� cont:� K :Designs 3 (vinyl siding%sf) 4 a s Ta/s Block' M. 1st Gri e ,021`060-009. s white ,house S Grl ey- ti �t Colusa Hwy, Gridley !,PADDA; KEWAL - --' 1537 BLOCK RD, GRIDL stir, (repairs) _ 3 �. 'ARE ROOF ` ' 'tr"# Y its' (',stucco' s s of house) j 1 F • I AFI ' - S,u,inr Y, 6Y.; - - ` �i •'• f... r l e - {{1 y J �1. .5�^6 �OtZ/ I X ` I` �,��i lu i1j�}�?�� . �Yp I�A•3� -y" ,a: ' PADDA OKEWAL��� w 03 199, s` ? I = � .1537 BLOCK'RD GRIDLEY raj f . y - Y a H L a ` , ., 9999 `• • t 3 NQS,, COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - B ILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone( 0) 538-7541 (-3-///7 PEn�rrJt� (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER ' - -,Ane T TELEPHONE I rfln SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS - "� 7 r J7 +i �!!`•• .]t\ rn T t'l1 n r/!/_A � \` � 'iv CONTRACTOR'S NAME' - -- 7 —'' "'� -s" TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ I i n ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 'i--R;3lF Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 000V OR LESS zooA oR LEss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. a ACC. BLDS. SO 3.5¢FT: NEW CONS � MULTI-OUTLETU. 97.50 POWERAPPARATUS & SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FDTTURES BAL @',50 Ex. Occup. our�is'REs 6.0 2A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating —Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 14 .4 ' • l x.41 ___ Date �/ - 41 _ Signatdr of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is c® wired f p q r,exr—av s over 5'0" deep and demolition or construction of structures oye. 3 s�o i — ,jght. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ An tX, HAZ. D. fE6 IMP FLOOD CDF pgRCEI pp HD ISSUr Vol This permit is hereby issued under the of `t�e Butte ¢8unty Codp and/or indicated a ve whic fees have B PERMIT EXPIRES ON ( applicable provisions Resolutions to do work been paid. / lJf/+ / L Date / D e Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION da 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 lz-, R (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ilk 1 _12, _ ZONING BUILDING PERMIT OWNER 1 TELEPHONE SO, FT, OCC. BUILDING VALUATION 19 @ 60 1149 .OWNERS MAILING ADDRESS Q 1537 B1012K CONTRACTOR'S NAME r, TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 29 00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ z, LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RE—ROOF Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AOR"E ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION by affirm under penalty of perjury that I am exempt from the Contractors License or the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DW EWNG OCCUP. OR ADDNS. ( a ACC. S. SO 3.5¢FT. � .ESID MUL 14I T 1 97,50 PSO APPARArus a SINGLE OUTLET CIR. EX. Occup. OUTLET OR FD(TURES 20 @.00 SAL @ 1.50 FIXyher Ex. Occu . otDR°EEk 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that 9 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X t Date (,_ i I_ to 3 Signature of Applicant - Owner Contractor ❑ Agent An OSHA permit is quire f ex v ns over '0"deep and demolition or construction of structures 3 Receipt No. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ Z, HAZ. D. FE6 IMP FLOOD I CDF PARCEL I PO HID ISS This permit is hereby issued under the of a Butte unty Co and/or indic d a v w is fees have By PERMIT EXPIRES ON Vp applicable provisions Resolutions to do work been pVd .14 D to 4 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name'and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing - your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide thpmajor labor and materials for construction of the proposed Property impfovement : YES EJ NO 132. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed.work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE:. CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person. to coordinate, supervise, and provide the inaj or work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME , ADDRESS PHONE TYPE OF WORK NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit OVER I OWNER BUDDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. . For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ Ifyou employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors; then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are . subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building --- -- - permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned rely, mic 1 C. Vi ira, C.B.O. er, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER .�',atzL.r`:. ,»� : � 1 ,-�;cF:. r`i -ilk . �.�q,,s•, -ry._�.�,..�,�.r�r.:�,3.{•�!•�•2'�.j1s�..,'.raj'?e'r7�''�r`'`:;?"N'y'��:;.-+,a''.l�fi'F;er,�,•,%^ft'�;���._y •p�rlr;.y�,e.e�r. y:ie .. 1. { • t.. a .{ ,.. `u, r , . 'A. .-.� .�. ''�i; �•� .. .. a �. f's { 21_06-09 2278-91B' • . BARTSCHI, Paul &Irene ` 1537 Block, Gridley *' cont: K-Designers y ' (vinyl siding/sf) t «« COUNTY OF BUTTE - D.EP.ARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION -AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING A q.r,BUILDING PERMIT OWNER '; TELEPHONE 5770 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILINGf.ADDRESS _ CONTRACTOR'S NAME ,� / TELEPHONE CONTRACTOR'S MAILING ADDRESS �^�.% F,?7 _ Fireplace CONSTRUCTION LENDER i UNKNOWN Total Valuation $ 7 111991 LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 10.00 Permit Fee $ Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS .: Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 55,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G WO.00ea J TYPE OF WORK New W Addition ❑ Remodel [JUtilities ❑ Installation[ -Other Describe work: y, S I I Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000 AMP V OR LESS 10.00 CONTRACTORS LICENSE LAW I declare under Snail of perjury penalty p f y (Check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. / License No. V 0f'1 Classification �' d � El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.y , OR ADDNS. ACC. BLDGS. /z¢sgft NEW CONSTRMULTI-OUTLET NON-RESID BRANCH CIRCU ITS 2.50 ea POWER APPARATUSe (SINGLE OUTLET CIR. ) zOeaOt EX. OCCUp(OUTLETS OR FIXTURES .ALO 30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ©, l have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shal I not employ any, person in any manner so as to become subject to the W. C. laws of California.til Notice to Applicant: If after making this statement;;should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Venation Pencil Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction; and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree -t6 save, indemnify and keep harmless the County of Butte against liabilities, judgments, costs, and expenses which may in any way accrue against,sai'd_County in cortsequence.of the granting of this permit. -7 __ Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ov(eerr 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 7,2 OCCUP. CONST.TYPCJ SCHOOL FLOOD PARCEL PDEND 17all This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECI, OF PUBIC WORKS BY _ /! 11 /yr ate PERMIT EXPIRES Date Receipt No. / WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541, `-'711 APPLICATJC�y'AND PERMIT ASSESSOR PARCEL NUMBER ZO ING 4 BUILDING PERMIT OW ER T LenHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING DOR S s3 s' CO TR TORS NAME TELEPHONE CONTRACTOR' AI ING DDRESS 31 , , , C� %,���% Fireplace CONSTRUCTION L DER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $. 10.00 Permit Fee ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER•S,MAILING ADDRESS ' _ Plan Checking Fee ,$ 'Energy. Plan Checking Fee $ .Penalty $ . BUILDING ADORES - As,37 Permit fee $ PLUMBING PERMIT Filingfee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. - SUBDIVISION NAME - PARCEL MAP Water piping '5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF 4Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 0.00ea TYPE OF WORK New QW Addition ❑ RemodelU Utiliti s ❑ I tallatio ❑ Other ' Describe work: Permit Fee .' `" $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2,50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and .Professions Code and my license- is in fullforce and effect. License No.—�/� �OO Classification 6"— 6/ F1Ex..Occup. I; as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am, exclusively contracting with licensed contract- ors. (Sec. 7044) F -1I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.DWELLING OCCUP.8J , h2sgft New CONSTR.(A MULTI -OUTLET NON, R ESID .BRA CH CIRC ITS 2.50 ea /POWER APPARATUS e (SINGLE OUTLET CIR. / EX. OCCUp(OUTLET50R FIXTURES 200601 , e AL030 FIXED PLNS�REA.) 2.00 OUTLETS (RESID I Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 .' 9 ` Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ ,I shall not employ any person in any manner so as to become subject to the W. -C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of.the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this applicatiori and, state that the above information , is correct. I agree to coMply to all County Ordinances and State Laws relating to building constructio , a`nd hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agr o save, i damnify and keep harmless the County of"Butte against all lia judgme ts, costs, and expenses which may in any way accrue against i C my i coCssequenc of the granting of this permit. / X r Date / / ,Sign ure of Applicant — Owner ❑ Contractor ❑ Agent ❑ An.OSHA permit is required for excavations over 5'.l)" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 7a, ,SD OCCUP. CONST.TYPL ISC11001- FLOOD PARCEL PD MD se This permit is hereby issued under sions of the Butte County Code and/or work indi d above for which IRE F PUB By. PERMIT EXPIRES Date the applicable provi- resolutions to do fee have been paid. C ORIKS e �Aq 9 1;1 Receipt No. WHITE-D.P.W.. YELLOW-AS8E330R. PINK -INSPECTOR. GOLDENROD -APPLICANT 41 IN THE WEST" KCN 3170 Fite Circle Sacramento, California 95827 (916 ' )361-8800 CA. Lic. #498806 TO: DATE: SUBJECT: BUILDING PERMITS 3 1'7 JOB SITE ADDRESS: PLEASE ACCEPT THIS AS YOUR AUTHORIZATION TO ACCEPT THE APPLICAT I�"0 ISS NG PERMIT FOR THE ABOVE DESCRIBED JOB SITE SUBMITTED Bf4 A REPRESENTATIVE OF K -DESIGNERS. PLEASE NOTE THAT THIS AUTHORIZATION IS RESTRICTED TO THE ABOVE DESCRIBED JOB SITE ONLY AND NO OTHER PERMITS ARE AUTHORIZRD HARE (B.D.) VIDLOCK TION MANAGER ..330 -- !�!,h •% , . So. Moolzt,111 59.07 -.1661 245-;i8()4 -§IGNATURE,,---;���� '825 W 6!n Ave 13446 Walsh Ave. ­lk—oau. Cniomoo 80224 Sania Cara, Cdidornia 95051 .!031 '.",:.0044 408) 727-,5800