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HomeMy WebLinkAbout0811A (4) , , - �.— --- ,�. N'DR6GI2S'CO\t19[N5.4TION[)F.CLAFtATION 7GF.38AC p�j � 1 haeby affirm that 1 huve a cer[ificalt of cument [o srlf CE-F37R(2-RO) A( r_L�C A.T I O R! �FO R P E R fdi IT insure,oraerrtificateoflCorkrrs'Compensationlnsurance,or ' HEATING•VEI�TILATING-AIR CONDITIONING ' u errtitied copy thereof(See.3fl00,Lzb.f.) , ''°r""°�65-80-18m��°�State_�md i � � C�rt�t�rd�opy I�hrrchy r��rn�sh�,i. COUNTY OF LOS ANGELES BUILDING AND SAFETY � ('crtified cu��y is filtd with[hr c��Unt}huildinF ins�+<c[i��n � 6UIL�ING� �� 'i Sep;ir�mrnt. , FOR APPLICANTTO FILL IN Uate APPlitan� (PRINT OR TYFE ONLY) aooaess � 72.�BTea._CanyIXl_P.c��B- , .: . � '.— �oc n�i rv':�dalLlut Cl:lt'I'l1�ICATI�.nl�F:X[=1f1'TION F�ii�]:�11':ORI:f�F'.S' NO. TYPc O�APf'LIANCE OR E(]UIPMENT FE� _ CO?iPGK5AT10N IASURp�CI; NEAqEST � fThis section necd not be complctcd if the r�orA imolved AC3SORPTION UNIT,BTU _ C:.OSS ST.� O Uy Ihc permi[ is for onc hundred dollars (5�00) u: Ics1.) ^ � o�s�n:crr�o PROCESSE�BY (J I cer[ify tliat in [he performance��t tfie����rl.t��r��hich t'iis ',Alf;FIA�.IDLING UNiT,CFh1 � �� �� permi[ix issurd.I shall not emploY���Y F�'rsor. in any ruun�•r I O so os to M1rcome subject tn the tCorkers'Compen}�tinr.L:iv... IBoiLER,ETV � �"'�� PpPqOVALS DATE INSPf,TOP'SSIGN4TUAE W'i D��e AVCli�anl � �CDR1PFlES.�,Of1.f7TU __ ROUGH 7 �' N��� NOTI(;F:TO AF'!'I.IC.ANT:If.afizr m:il:i�'.E tliis C:��rtifica[��iit V[�.TIL:,TION SYSTERt I FINt,L ��/ z:l, Cxemp[inn. 5'���� Shuuld becnm� suUJu�t In the \5'url:ers' _ ,_ _ C�,mp��s:,c���� pr��.�s��ns�,r mc�anor c��de,ym�must r��nn- Evnao�eanve coo�E�+ � VALIDATI N with eomply �eitL• such provisionx or thic permit ahsll hr _' , deeme�l revnFz�. � FURNACE:� FAU—_GF7AVITV_ '. LICLtiSGf7 COtiTItAC7'OHS pIfCl.AltAT10N FLOOR; OYU_ �` 1 het�by affirm tli�t 1 um IicenseJ undrr�r����isiunsnf Cha{�1�•r HEL�iEn: SUSFEND[D UNIT i , ' 9 (cnmmrncing with Sectinn 7000)uf Uivisiun J of thc Ruai� uVnLl � . � nrsc and Prt�f�ssinns Code.and my Iicense is in full faree and � ---�-- � � crr�c�. ' _2__�_$athsoom_fans 0-00 ' License Number Lic.CI.iS. �. I Con[ractor^ Date � � � � �� '� � I am e�empt frum the licen<ing req��irer.icnts ac I.im a ��_ --_---------- ' . �� licrnsed archltcct or a registered pmf�ssivnnl enginrer Pla��chCCk fee 25°b of Bbove. . i. acting in my professionsl copueity (See[ion 7051. 13ue- --------- - ' ', inrss�nd��ro�rss�ons Codc). • PERMIT ISSUING FEE S $ 5O :'_C S� � I�, Lic.or Re�;.ho. D�ic --------_�T07AL FEE _ 18�0 r • • o��:(?� Ilptif�O\V'Ni:;It-pU1L[)FIt 1)i':CLAI{ATI(1� PLAN CHCCF:A��LICF.NT ' '� �y� �J(;� . ', 1 hereby affinn �hat I am �zemV[ tYom�the Contr:�ctor's NAME'--_�- � s �• � �j r�(.�� �'� Liccnse Law for the totluxinS reasun (Section ^O71S, Siu.i - � � � ��� iiess and Prokssiuns Code): nD�RESS [;�i 2�',-� I . � ! as o�vnrr of the propert3'.���ill dn �he ���orF and [hr strucfure is not intendrd nr u(fend for sale (5.•ctiun ��T�� TEL.NO. I I 7044.Businezc and Yrufe�sions Coda). ---� . . . �I � o•r,�,e��ea_Homes I,as o�.�ner uf thr proprrty,am esclusivel5 �'��ntr�cting _ �. �vitti licensed eontmc[ars tu construct the Crolec[ n9AIL 655 BT23 C2T1 OIl RCl. � � � �� (Sec[iun 7044.fiusine+s and Professions Code). nDDRE,._ y ! COhSTRUC710N LLNUWG AGCtiCY ��TY Wa�Tlut T��."0.598-1841 ��, � —_.___- - � i I he[ahy� afCirm thut Ihere i i constructi��n Icndinb ag�ncp ^�,. �i I (uf the rClfof�n;lnCC <�f IheytvOfk f[it 1�'hiCh II�iS ��e�mit is CONTRACTOfi O.C.Clln�te Wl•1�••�l� InL•._ ' ' I issued($eC.3097.CiV.C'.). -- , ' LunJer's�a�ne qoon[SS 2852 $ kTd].put , I il Lendrr'sAddrexo '�CITv 7[L.NO.OoO L-t �� . ' I ccttit� that 1 I�arc rcad this lic�cion anA st:itc Ili�t [hr 'Pl1ct711 V.JV-V/�2— � i � � j } +I�1� "TAT[ LIC. abuve inrurnmtiun ic correet.1 asre,tn romp�y��ieh a�t Cnunry� i.iec-.�sF rin_��_372593 - -- -eLnssC-2� , . . . .. urdinsncrs und tiCitc la�es rcguiating He�ting,�'rntil.rting:md � --- --- . Air Condi[ioning,und herrby uinhoriir rcpresentutiv�rs oY tliis tii7f It1:VGlt51�:1'OR GKNLAN.ATORI'LA\GUAGF: . . . i County in enter upon [6e ubove-mrntioned prul`�rt>� fur � . i '. I � iusv cti,�p••pases. � ��-z�����-a6,8/ � . 5;,�����.. ,��,.���;�«<. ,�.<<. INSP£CTOR'S NOTES � O��'NFF.•�U[LDEf:DLiCLAR,`.TIOi� � �, 1 hcreby attlmi Itta[t am c�cm�+t froirr�heCnn[ractor's - - I.icensc lau� for tLc Colloning rcason(Srcliorz 7031.5, � �• � . Ettsir.eta m�:l Profers:or.s Cod:J: Ar,�• rrry� nr roW�f}� � x•kich rcyui.•cs a pcnnit ro cor.rtn�ct, cltrr, rrp�rorc. , � .. . . . . . • • dtntolisi�.or rcpair arry statcture.prior to hs rsso�¢rtcc. � alro requi.�es 16e applicent fo�sudr pemrit to fi(e c � - . ' . siSr.ed r7alcntent fl:at !re is liceitsCd purs�+ant to llic proria�ia�r of tire Co�itrcelor's I.irenae Lex�/Cha{>ter 9 . (tormnertrinS �citG Secfion 70QC1 of Diri,vron ?oj dee � l3usir�e.cs crrd Fro7es.crorrs Codef or Ihal Le is e.rrmpt � thcrefram nnd tl+c Gntis far tltc plleged ex��rir�otion.,-1nv � . - _. � . - , � rrolarioir oj Seerion 7U3L5�r anl'ePPlicm+t fo.�a penrei� ruhjrcra tlie apP���Q^r ro a riri!penalrp of rmr nrore tkan � - �. . fice frtuidred doflars($SOOJ.: � . ❑ I.os otincr uf tLc pro�crf}'�cill do Ihc�earA.anJ � � . �hc s[ructucc is not in�cnJcd ur oll'end tar sal,. .. � , . � . ISrc. 70�1». l7irsincst c�+d Prnfcsiio�u Corl:: Ti�r Co:+� . . 7ruclor's I.ircrcte Law diies unr app!}�to me o���ner nf property x�ho hurld:or in+psa:es 1L��rrnr.,m�d�rho does - rarl� worA hirrt.tr!/ prorided N�at such i�upro�'ements aYC uot inlcnded or oJfcrcd fnr aalc. lj. l�nt.t�rrr. rfrc ' ' buildrrtg or i�rrprorcmeur ix sold n'i�Hiu ane year of - canpletior.. �ire mtvtrr�builder will Gm•e !/te burdem of prr ring titat Le drd rtot build nr imprtirr for die . �' . . .. ' nurpnscofsalc.` - . � .�. � I, as oMncc of thc pruperty.am c�clusivciy con- tr�ctin;o�i�ii licenced cuntr�ctnn to construct thc project (Seetior: :03-1, F.usinri�c a�:d�Hnfes.dau Cude:Tlre Con� tractor's I.kcnsc Larv Aoes not ep�1y fo mr owncr oj propert�� whu builds or i�nprorrs tLcrcon. mu1 x•!ro. euutructs for sudi prujcr�s n•idi a co�ttractor/sl liccnsed � � . p�trsuartt 10 1Lr Onrtraelnr i�Liren.ic l.mvl. 1 am cxempt under Sec. I:&P.C.fur thi�rca.un Uate . Q�cner , INSPECTOR'SNOTES � � • � � � - � - ' ' � •- • �