HomeMy WebLinkAbout12_03_1982 - 1817 PEACEFUL HILLS RD «���,thLaS'�o^,�°F.vs:�T��v���:��^IZ�T�o^ CEA818c12-60) ,4PPLICATION FOR PERPv91T
I herehy afPirm Ihst.I ha��e a certitica[e nf con<ent to stlf
insure,oracertificateotWorkers'Cnmpe�s�tionlnsurance,o� HEATING-VENTILnTING-AIR CONDITIONING '
u certifiPd cnpy Ihereaf(Sec.7R00,Lab.C.) • . .
�,�,i��v��. 306-82�„mvg���;='- St. Cor!p. Ins. Fund
� Certified copy is her��;y-�urnishee. COUNTY OF.LOS ANGELES . BUILDING AND SAFETY
I Tr. 325 6 I t
� � Certified copy is fiied�cith�he county huilding inspectinn BUILOING �
�p�,,,�,m,/,,,. FORAPPLICANTTOFILLIN Aoopess 1£i17 Peaceful Hills P.d.
Da[e 12L3Ls2 Ap���c;int Linda Sands (PRINT OR TYPE ONLV)
� NO. T�'PE OF APPLIANCE OR EDUIPMENT FEE LOCALITV piamon IS3T
CGRTIFICATE OF EXE�IPTION]'R0111VqRKERS'
iCOl1P[NSA7i09I'.�SU1E,4NCti CROSSST. }
� (This scction need not be completed if Ihe a�o�k invoh�ed A�SORPTION UNIT,6TU a
by the permit is for nne hundred doltars (5100) or IessJ OISTRIGT NO. F.�CESSEO F �
I cer�ify that in the perfnrmance uf Ihe�cork for�uhich this A�R HANpLING UNIT,CFM17 �
permit is issueA,1 shall nnt e:npinc any prrsnn in any manner (qTJ � —
so as to bemme subjec[to the 14orkers'C��mpensa�ion Lsws. 6DILER,BTU �
AF'PROVALS DATE �NSVECTOR'SF �ATUaE U
Uatc APP���a�� COMPRESSOR,BTU
ROUGH d
NOTICIi TO APPLICAN7:If,af�er making this Certificate of VENTILATION SYSTEM —
'_��tion,� you shuuld becoma suhjecl tn the \Vorkers' 3 18 �� FINAL Z
J�mpens§tinn pro�i�i��n�ut�h�Labor Code,you mi�st fnrth- EVAPOAATIVE COOLER VAUDATION
with enmply �cith 5uch p*ocicions or ihit permit shstl he
dcemed revnkeJ. FURNACE: FAU—GRAVITV
LICIiKSh:DCOVTAACTORSI7f:CI..VtATIOV FLOORr B7U �
[hereby affirm ihst f nm licenscd under rrnrisions af Chapter HEATER: SUSPENOED UNIT �
9 (commencing wi[h Section 7000)nf Uivisinn 3 of�he Busi� WALL '
ne5s and Yro(essinns Code,and my licrnse is in full farce and - .
efCect.
J License YumUer_�J�� Cic.Class C-43 .
} Cnntr:ictor $uim�it Date 12/3/82 `�
� � l nm exempt trom the��censin�reyuirements as t am a -�4 6 6 6 A s;"�
ticensed architect or a rcgistered protrssional enginaer Plan CheCk fee 2590 Of aboVe. �;. • •�• .a �
� aeting in my prnfr:�ion�t cap�city (Section 7051,Dus-
- iness and Professinns CnAe). � PERMIT ISSUING�EE$ 10 S� � - ,
-Lic.or Iteg.No. Uate� TOTAL FEE 2.$ Jr� ��• •2 8'5�
1f0111i OR'NtiR-13UILDGR DECLAR:�7ION pLAN CHECK APPLICANT • '2 a 5 O�
I hzrehy affirm that �1 am exempt frnm�[he Con[ractor�s NAME Sumr.+it Sheet Pietal Co. Ine. . I 2 0 6—S 2
License I.aw for the following reasnn (Sation 7031.5, flusi-
neSS�nd ProfeSsinnS Cude): ADDRESS 21511 Belshire $C.
. � I, as u���n�r of[he proprrir,�cill do lhe work and the CITY TEL.NO.
structure is not intended or offer2d for sate (Sectiun Hatoaiian Gardens 527—II863
9044,13usinrss nnd Prn(e�cinnc Code). � �
� 1,as nwner of the proper�y,am exdusively cuntraclinC OWNER t•�� J. �rOC�: Ft COTSS� T11C.
vi[h lirenstd con�ractors to consttuct the ptoje�t MAIL 169t3 Greenbriar Lane �ZZ�F
(Section 7094,itusineaz;md Yrnfeninnx Code). ADORESS f
CONSTRUCTION LGNUING AGLNCY C�TY Brea TEL NO. SZ9—SL7O '
I herehy a((irm thst thrrt ic a cunshuction Iending agency � ,
fur [he performanre nf the �cork for which this prrmit is CONTRACTOR Sur.�nit Sheet 2�fetal Co.. ZAC.
issurd(Sec.3097,Civ.C.). '
Lender's M1�mr ADORESS 21811 Belshire St.
LenAer's Address ciTv ga�^aiian Gardens TE�."0.527_Eg63 � �
t cer[ify th:rt 1 have read this applic�tion �nd st�te that Ihr STATE IIC.
aho�'c inform��ion is currc�t.I agret t��[u�n��ly��'i[h:fll County LICENSE NO. 19S�3Z � CLASS C.—�i3 � �
ordinances and Statz la�s's rcgulating Ifea�ine,VrntiWting and �
rlir ConditinninK,and hereby authorizc rcpresentstives nf ihis SIiF.RLVERSf.FOft EXPLANATORY LANCUAGL �
Cnunty to enlrr upnn Ihr ahov� rntiuned proPertY for �
� ��r ��>��r���r,s�5. 12/3/8?.
Si aturcnlYermittee Uate
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