755 S GOLDFINCH WAY (5)Permit Types
B1.D EL -c MEC PLM
I
Permit Number: BLD2022-04446
Issued: 09/16/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 210
CITY OF ANAHEIM
Site Address: 755 S GOLDFINCH WAY, ANAHEIM, CA 92807
Legal.Descriptl 'fi N:TR'8465 BL'K LOT. 31
APN:-36533308 .
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765.5153
t
Project Description: Reroof: Tear off material to install 30 squares of tile on house and attached garage. (ESR #1900)
Living Area: Number of Stories: 0 Valuation: 25,000.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: 589.25
People Associated with Project:
Permit Applicant Sumarlei Vazquez Contreras
Owner MOELLER MARSHA TR THE R 4721 E CODA DORO
Type Electrical Fixtures Qly Type Plumbing Fixtures Qty Mechanical Fixtures Qty
e
The permit shall expire by [Imitation and become null and void If the building or work has not passed final Inspection 365 days from the
date of permit Issuance. A new permit Is required to commence or continue work.
P�PNEIM �qC FINAL INSPECTIONS DP,.7E INSPECTOR
Cityof Anaheim o� io All applicable items below must be signed before utilities are released
Building Division F z Final Gas Test
u > Electrical Final
Plumbing Final
�DUNDED a�^ Mechanical Final
Cross Connection Control (714) 765-4280
Do not occupy this building until the final inspections have been made. Engineering Final (714) 765-5126
INSPECTION I DATE I INSPECTOR
Fire Sprinkler (ONLY) (714) 765-5041
Do not pour concrete until the following applicable items have been signed:
Fire Dept. Final (714) 765-5041
Plumbing (Ground/Underfloor Drain Waste)
Water Engineering (714) 7654591
Electrical Ground ElectrodelUfer
Sub ListlBus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches; (Footings)
COA/Mi ation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
sianed7
Bu ding Final ( 14 765-5153)
al Only After Above Comle
Z
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girdem)
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundation Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been s'
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor ear
Vqdf—(SheathI4Diaphragm1Frame)
Masonry (Reinf.IBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COAIMitagation Measures
Plumbing Inspections
Framing (Only after Plbg., Ele., Mec. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele, Mec & Plbg)
Interior Lath
Exterior Lath
Electrical Inspections
Electrical Service Meter-(Meter will be set within 2-3
business days after approval) Excludes New
Construction
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mec.)
Grease Interceptor
(Do not backfill unless smaned ofn
Sewer
Water Engineering Backflow (Testable Only)
Water Service
4b
BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODE CYCLE
Anaheim, CA 92805 01/01/2017
714 765-5153 EFFEC77VE DA FE
wwwanaheim.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
• Final Inspection approval will require this completed form to be on site along
with the job card.
Permit Number. — 4 �� �„ Date: 1 % ?i( /Z
Project address: S - �,�/�
Property Owner: IM o P_lt e
The undersigned does hereby certify that I am the property owner of the above referenced
property. I further certify that smoke alarms and carbon monoxide alarms are present and
functional in all the following locations. All boxes must be checked below
JE0moke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
Smoke Alarms: In each room used for sleeping purposes.
Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door between
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower level provided that the lower level is less than one full story
below the upper level.)
All dwelling units#vlth attached jgarages require carbon monoxide detectors.
Signature:
6117,4 /7-
California
Z
California Residential Code (CRC) Section R314.6.2,CRC R315.2 states in part that existing dwellings be
"retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as
indicted above.
NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim
Inspector is not achieved during the course of project construction. It is normally used for exterior projects such
as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work.
200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765.4607 Fax FEB 2018
www.anahelm.neltuilding B842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Bedroom Bedroom
6 6
0
Kitchen
Living Room
Figure 1
Bedroom
Living Room
Attic
0
640
Basement
Family Room Bedroom
Dining
Living Room
Kitchen
Bedroom Bedroom
Figure 2
6
Bedroom
Kitchen
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION
V
Acceptable -' Never-/
Here Here
Top of Detector
Acceptable Here
Garage
Figure 4
MOELLER RESIDENCE
755 S Goldfinch Way, Anaheim CA 92807
Executive Summary
The purpose of this report is to act as a summary of findings for a structural survey performed at the project address noted above. The purpose of the
structural survey was to identify and map the existing roof framing members in preparation for the re-lay of the existing roof the or the installation of new
roof tiles. Regal Structural Group has performed the structural survey, run the applicable structural analysis to justify the increase in roof loading, and
prepared this report in order for the project to receive approval through the Governing Jurisdiction.
Client Information Homeowner Information RSG Project Information
Company: Premium Roofing Systems Name: Todd Moeller Project No: 22-170
Address: 2054 Continental Ave Address: 755 S Goldfinch Way Report Date: September 15, 2022
City, State, Zip: Costa Mesa, CA 92627 City, State, Zip: Anaheim, CA 92807
Site Visit Date: September 15, 2022
Site Visit time: 10:00am
EXISTING ROOF: Cal Shake Tiles = 5.9 psf _
NEW CLASS A ROOF: Eagle - Eaglelite Bel Air (7.2psf) [IAPMO ER -19001 _
PLAN NOTES:
1) THE ROOF SLOPE IS 7:12 (UNO)
Zk 8 & zof Or.
Zx8e w0L
tzxloC-14"&-
`zx8e- z41z'
6x8 ti4"a-
�x/6
gx/o •-
2) ALL FRAMING INDICATED ON THIS PLAN IS EXISTING UNLESS NOTED OTHERWISE
QROFESSt-
���4,0. OLAS
071-v.i,T�i/.iE
VQ�
3) THE CONTRACTOR SHALL VERIFY THAT THE EXISTING FRAMING SIZE AND SPACING MATCHES THAT SHOWN ON THE ROOF PLAN. SHOULD THERE BE A
DISCREPANCY, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY SO THAT AN UPDATED REPORT CAN BE PROVIDED.
4) THE SPAN INDICATED IN PARENTHESIS IS THE MAXIMUM SPAN FOR THE FRAMING IN THE GIVEN BAY. SHOULD THE ACTUAL HORIZONTAL SPAN (NOT SLOPING
SPAN) EXCEED THAT SHOWN, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY SO THAT AN UPDATED REPORT CAN BE PROVIDED.
5) WHERE THE EXISTING FRAMING COULD NOT BE VERIFIED IN THE FIELD DUE TO LIMITED ACCESS OR WAS COVERED WITH FINISHES, IT IS NOTED WITH AN
ASTERISK(*). IN THESE INSTANCES THE CONTRACTOR SHALL VERIFY THE FRAMING AFTER THE EXISTING ROOF HAS BEEN REMOVED AND NOTIFY THE ENGINEER
IF THE EXISTING FRAMING DOES NOT MEET OR EXCEED THAT WHICH IS INDICATED IN THE REPORT.
6) FRAMING SHOWN HAS NOT BEEN ANALYZED TO SUPPORT STORAGE LOADS. WHERE STORED ITEMS EXIST ABOVE THE EXISTING CEILING JOISTS, IT SHOULD
EITHER BE REMOVED OR ELSE SPREAD OUT SO AS NOT TO EXCEED MORE THAN S POUNDS PER SQUARE FOOT.
Page 1
GOVERNING BUILDING CODES: DESIGN STANDARDS: LOAD COMBOS [ASD]:
2019 California Building Code (2019 CBC) ASCE 7-16: MinimumDeslgn Loads for Buildings and Other Structures D + Lr (Equation 16-10)
2019 California Residential Code (2019 CRC) 2018 NDS: National Design Specifications for Wood Construction
DESIGN ASSUMPTIONS:
As -Built Information:
1) The following Adjustment Factors are taken as 1.0: CAF, C, Cb„ C;
Design Parameters:
2) The compression flange of the members are braced per NDS 4.4.1 [CL =1.0] _
Size: 2x8
3) Shear is calculated at a distance'd' from each support
Co: 1.25 E' (psi): 1,600,000
4) Roof Live Loads are calculated from Table R301.6 (2019 CRC)
As -Built Information:
5) Roof Dead Load Summary below does not account for the member weight. Refer to each member
calculation for DL including self -weight (SW).
6) Density of Douglas Fir -Larch is assumed to be 31.21 pcf
Design Parameters:
7) All beams are assumed to be simply supported. V=wL/2 M=wL`/8 D=Swo/384EIx
Fb (psi): 900 DnALL (in): 0.80
8) Design checks based on the Design Provisions of NDS Chapter 3: fb = M/Sx (3.3-1) f„ = 3V/2A (3.4-2)
TYPICAL ROOF DEAD LOAD = 9.9 psf VAULTED ROOF DEAD LOAD =
14.1 psf
'rile = 7.2 psf Tile =
7.2 psf
Underlayment = 0.2 psf Underlayment =
0.2 psf
Sheathing= , 1.5 psf Sheathing =
1.5 psf
Miscellaneous = F 1.0 psf Insulation =
0.5 psf
MEP = 1.0 psf
Gyp Finish = 3.3 psf
y Miscellaneous = 0.5 psf
MEMBER J1- 2x8 @ 241n OC
As -Built Information:
Section Properties:
Design Parameters:
Loading Criteria:
Size: 2x8
b (in): 1.50 Sx (in'): 13.141
Co: 1.25 E' (psi): 1,600,000
SW (psf): 1.18 ROL (lbs): 212.26
As -Built Information:
Section Properties:
CF: 1.20 F'b (psi): 1,553
Cr: 1.15 F'„ (psi): 225
Slope Adj: 1.16 Ru (lbs): 192.00
DL 17.7
Design Parameters:
A (Ina): S, (Ina):
IF (in 4): 2.039
Fb (psi): 900 DnALL (in): 0.80
Loading Criteria:
Material: DF -L No. 2
Size: 2x8
b (in): 1.50
Sx (in):
13.141
Co:
1.25 E' (psi): 1,600,000
SW (psf):
1.18
ROL (lbs):
181.94
Trib (ft): 2.00
d (in): 7.25
Ix (in 4):
47.635
CF:
1.20 F'b (psi):
1,553
Slope Adj:
1.16
Ru (lbs):
228.00
Span (ft): 14.25
A (In): 10.88
SF Qn3):
2.719
C,:
1.15 F'„ (psi):.
225
DL (psf):
12.8
V (lbs):
410
Pitch: 7:12
IF (in°):
2.039
Fb (psi):
900 DnALL (in):
1.43
Lr (psf):
16.0
M (Ib -ft):
1460
Material: DF -L No. 2
Fv (psi):
180 DLrALL(in): '
0.95
w,L (pif):
25.54
Dn (in):
0.70 OK
Vaulted: No
wu(plf):
32.00
DCR=0.25
D,r(in): •
f, (psi):
0.39 OK
56.5 OK
I
DCR=0.86
fb (psi):
1334 OK
Member is Structurally Adequate
MEMBER J2 - 2x8 @ 24in OC
As -Built Information:
Section Properties:
Design Parameters:
Loading Criteria:
Size: 2x8
b (in): 1.50 Sx (in'): 13.141
Co: 1.25 E' (psi): 1,600,000
SW (psf): 1.18 ROL (lbs): 212.26
Trib (ft): 2.00
Span (ft): 12.00
d (in): 7.25 Ix (in 4): 47.635
10.88 2.719
CF: 1.20 F'b (psi): 1,553
Cr: 1.15 F'„ (psi): 225
Slope Adj: 1.16 Ru (lbs): 192.00
DL 17.7
Pitch: 7:12
A (Ina): S, (Ina):
IF (in 4): 2.039
Fb (psi): 900 DnALL (in): 0.80
(psf): V (lbs): 404
Lr (psf): 16.0 M (Ib -ft): 1213
Material: DF -L No. 2
F„ (psi): 180 Du ALL (in): 0.60
WOL (plf): 35.38 Dn (in): 0.41 OK
Vaulted: Yes
wu(plf): 32.00 Du(in): 0.20 OK
DCR= 0.25 f„ (psi): 55.8 OK
DCR= 0.71 fb (psi): 1107 OK
Member is Structurally Adequate
in the Field
i2
�8
f
i OK
I OK
I OK
i OK
inthe Fiela
A
10
i
OK
I OK
i OK
OK
r `,
The following table provides a summary of the preceeding analysis and indicates which members (if any) require further field verification or strengthening.
When strengthening is required, refer to the Roof Plan (and associated details when applicable) in this report for specific information about the strengthening
measures required for this project. Any required strengthning shall be completed prior to the installation of any new roof loads. Refer to the Terms and
Conditions section of this report for additional information about the means and methods of construction.
Member ID
Is Field Verification by Contractor Required?
Is Strengthening Required?
J1
No
No
J2
No
No
J3•
Contractor to Verify Member Size and Spacing in the Field
No
J4•
Contractor to Verify Member Span in the Field
No
is*
Contractor to Verify Member Span in the Field
No
A
No
No
B1'
Contractor to Verify Member Size in the Field
No
B2
No
No
SEAL AND SIGNATURE
The preceding structural analysis has been performed by Regal Structural Group expressly for the project located at 755 S Goldfinch Way in Anaheim,
California.
The analysis and recommendations are based on the as -built conditions at the time of the structural survey noted in this report. Any alterations or
modifications to the existing roof structure after the survey date have not been taken into account. If any modifications have occurred, further investigation
and analysis would be required prior to implementing any reroofing or strengthening.")
Se -"4r ptember 16, 2022
Nick rphy P.. Principal DATE
COMPANY INFORMATION
3857 Birch Street #282
+-i Newport Beach, CA 9080
3
t (949) 292-1987
REGAL STRUCTURAL GROUP
QRpFESS/pyq
�QQ�.•;rpLAS A9G� .�`y
LU:: No. 71600 :M
* : Exp. 12131/23
d'jplCIVIL �a\Q
F OF CAU
SEAL
THE ISSUANCE OF THIS PERMIT DOES
NOT APPROVE VIOLATION OF ANY OF
THE BUILDING CODES OF THE CITY.
THE HOLDER OF THIS PERMIT
PROCEEDS AT HIS OWN RISK.
SEP 16 2022
BUILDING DIVISION OF ANAH
APPROVE W
OW2.022 -oq%4
Page 4
In accepting this report, the Owner or Owner's Agent agree to all the terms and conditions noted in this report.
STRUCTURAL SURVEY AND EXISTING CONDITIONS
Since base building structural drawings are not available for review, all information relative to the existing structure shown in this report is based on structural surveys
performed by Regal Structural Group. In some instances, verification of existing framing is not possible due to existing finishes and/or obstructions in the existing attic
space. where the existing framing needs to be verified during construction, it will be noted on the Roof Plan in this report. Any plans and/or details contained in this
report are not drawn to scale and may not accurately represent the field conditions. It is the Contractor's responsibility to verify all field conditions prior to the start of
work and notify Regal Structural Group immediately if the as -built construction does not reflect that which is shown in the plans and details. The Contractor should
replace, in kind, any damaged or rotted members that they encounter during construction.
SCOPE OF STRUCTURAL ANALYSIS
The structural calculations contained in this report are for the evaluation of the existing roof framing members to support additional dead loads due to the increased
weight of the new roof finishes. The analysis contained in this report is for gravity loads only and does not take into account lateral forces such as wind and seismic. The
existing structure's ability to resist lateral forces is outside the scope of this report. Regal Structural Group makes no warranties or guarantees with regard to the
existing structure's ability to resist the lateral forces.
The Home Owner agrees to indemnify and hold harmless Regal Structural Group and their consultants relating to any potential damage caused by wind or seismic activity.
All calculations in this report are in conformance with the governing building code and design standards noted in the Existing Framing Analysis section of this report.
NON-STRUCTURAL ELEMENTS
The Home Owner is aware that the additional weight of the roof tile material may cause additional deflection of the existing roof members. These deflections are
cosmetic in nature and, in most instances, do not jeopardize the structural integrity of the roof structure. The added deflection due to the additional tile weight may
also create cracking in the existing building finishes. Generally speaking, this cracking is non-structural in nature and should be repaired, at the Home Owner's expense,
after the new roofing material has been installed. The attachment of non-structural elements such as HVAC units, lights, fans, etc. are the responsibility of the Architect
or Designer unless otherwise specified in this report.
MEANS AND METHODS OF CONSTRUCTION
Any details contained in this report represent the finished structure and do not indicate the method of construction. The Contractor shall provide all measures (i.e.
bracing and shoring) necessary to protect the existing structure during construction. All construction materials shall be spread out when placed on framed roofs. The
material loads shall not exceed the design Live Load per square foot that is indicated in the Existing Framing Analysis section of this report.
LIMITATION OF LIABILITY
To the greatest extent allowed by law, the aggregate liability of Regal Structural Group for any and all injuries, claims, demands, losses, expenses or damages, of
whatever kind, arising out of, or in any way related to the services provided by Regal Structural Group on this project, shall be limited to $5,000 or the total fee received
by Regal Structural Group, whichever is greater. Further, no officer, director, shareholder or employee of Regal Structural Group shall bear any personal liability to the
Home Owner for any and all injuries, claims, demands, losses, expenses or damages, of whatever kind or character, arising out of or In any way related to the services
provided by Regal Structural Group on this project.
The Home Owner hereby agrees to indemnify and hold harmless Regal Structural Group and its authorized employees from any action, liability, claim dispute, loss,
damage, or injury to persons and property in any manner arising out of construction and/or any incidents involving the condition or security of the premises and its
contents over which Regal Structural Group has no control.
MEDIATION
All disputes between the Contractor and/or Home Owner and Regal Structural Group arising out of or relating to services provided by Regal Structural Group on this
project shall be submitted to nonbinding mediation prior to commencement of any other judicial proceeding.
DISPUTE HANDLING
The Home Owner shall make no claim either directly or in a third party claim, against Regal Structural Group unless the Home Owner has first provided Regal Structural
Group with a written certification executed by an independent professional currently practicing in the same discipline as Regal Structural Group and licensed in the state
of the subject project. This certification shall a) contain the name and license number of the certifier; b) specify each and every act or omission that the certifier
contends is a violation of the standard of care expected of a professional performing professional services under similar circumstances; and c) state in complete detail
the basis for the certifier's opinion that each such act or omission constitutes such a violation. This certificate shall be provided to Regal Structural Group not less than
thirty (30) calendar days prior to the presentation of any claim or the institution of any judicial proceeding.
CONTRACT ADMINISTRATION
It is understood that Regal Structural Group will not provide design and construction review services relating to safety measures of any contractor or subcontractor on
the project. Further, it is understood that Regal Structural Group will not provide any supervisory services relating to the construction for the project. Any opinions
solicited from Regal Structural Group relating to any such review or supervisory services shall be considered only as general information and shall not be the basis for
any claim against Regal Structural Group.
DISCLAIMER
The opinions and conclusions developed in this report are based on engineering judgment constrained by the limited scope of the investigation noted above, consistent
with that level of care and skill ordinarily exercised by members of the profession currently practicing in the same locality under similar conditions. No other
representation, expressed or implied, and no warranty or guarantee is included or intended.
COPYRIGHT
®Copyright 2022 by Regal Structural Group. All rights reserved. No part of this document may be reproduced or distributed in any form or by any means, or stored in a
database or retrieval system, without the prior written permission of Regal Structural Group.
SIMPLE.e&f . SOLUTIONS.
from a com anYY you can trust
p
ROOF/N6 PRODUCTS
Eagle Tile Product Specifications
297 Slate Range
Profile Weight Description Category
Bel Air Lightweight Range of Charcoal Lightweight
Regions Available
California, Intermountain, Southwest
www.eagleroofing.com
Ref Aged Ref. (3 yr) EMI Aged EMI. (3 yr) SRI Aged SRI (3 yr) CRRC
0.15 0.17 0.94 0.92 15 16 0918-0046
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-04446
Issued: 09/16/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 210
CITY OF ANAHEIM
Site Address: 755 S GOLDFINCH WAY, ANAHEIM, CA 92807
Legal Description: N TR 8465 BLK LOT 31
APN:36533308
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765-5153
WORKER'S COMPENSATION DECLARATION:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to selfoinsure for worker's compensation. Issued by the Director of Industrial Relations as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
y I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
this permit is Issued. My workers Compensation insurance carrier and policy are:
Cartier: CLEAR SPRING PROPERTY AND CASUALTY COMPANY Policy No.: CWC00288900 Expiration Date: 11[82022
(
Name of Agent: GAA92" Phone No.:
I certify that in the performance of the work for which this permit is issued, l shall not employ any person In any manner so as to become subject to the
workers compensation laws of California, and agree that, if I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
R �tb JZ -L
Signa re of Applicant 61UV Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is Issued
(Sec.3097.Civ.C):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of DhAsion 3 of the Business and
Professions Code, and my license is in full force and effect.
NUMBER EXPIRATION DATE LICENSE TYPE IS
1042214 07MI12022 C39
Date
-7%16 1 Z2