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HomeMy WebLinkAbout1833A (11) «�«E��:,{S�Ca,t����.s:.T,��»����.��"„��. �fA��°� Af'F'LIC�TIOP�! FOR E�ERf��I'�' 1 hrceb5" afFirm [hat I hare a certi(icat: uf consent tn se1( cE.aia tzeoi � � insure,oracrrtiflcatr�d�corkcrs'comprns�uo���sur�n��,��r HEA7ING-VENTILl.TING-AIR COt�lDITIONING a ce�e)i/C1e(dfony thercnf(Sec 3a^0.L:-�!6�.('.//)�� ��1 � 1'nl i`.�,Y?+���-,�C'.o m p�n�7Q/=}'.LJ/I�y �i ❑ Certifird copp is herehp(urnishrd. � COUNTY OF LOS ANGELES E3UILDING AND SAFE7Y � CertifieJ eop}'is filtd v:ifli the COUntl'huildin�r insFrcti<�n 6UILDING � .�j d�p�rtmant. FOR APPLI CANT TO FI LL I N D�te Ap�Iicant� ICi11NT Ofl TYP[UNLY) ADOFE55 �,�ZA. �,1J��?��r LOCALITY ^/ C7iRTIPICATEOI'}:XI'\1PT101:1'I:O�t 11'pRF:k:li5' fJO. TYPE qF FPPl1ANCE OR EQUWM19ENT FEF NFytJ_% CO`.11'L:NSATIOI�I'VSl!{?A1C1; NEi1FlE57 ' . (This Section neetl not bC comrl�ted if the �t�or3: in�'Ol�'ec'. AfiSOF;PTIOPJ UNIT,BTU I CftOSS$7, �I�� q 6y the permit is fur onc hundccl dollars(SI00)nr Iass.} — o�;ri=„cr No. av-.;esse�ev � � c��i�rr e���e ������- a��m,��z��r a:e«�<,�t.�'„r���i,��n d,�> aiea�inNo�wc uviT,eFnn V �"` - permie iti issued,I shull nn[emplo}�ny pecson in nnc manner � � 5o as tn tiecome su6ject t�lhe��'��rAets'(:omprns�[i<irt Lu��".- �OfLCq,CTV_ �v�� � �� '-�� !;F'PROVALS DATE���NSPEc .��'SS�Gvn1uRE U Uute :'1pPlicsnt ______ W ICOMPRESSOR,C3TU ROUGH �' NOTICI'.TO.AI'VL1C:\tiT:If.aflc[m:tkin3 Ihi,(;rtll(li:ttv't�f I VENTILATION�VSTEn1 4� � Z 4:zrmption, you shuuld hecume suLject tn the P:urkers' f1��n� _ Compens�tion pr4�ision<of thr Lat�or Cod��,you must(�rt:i- � � � wun c<m i �t��n t�ch p��m�c si��u ��� IEVAPOFf,TIVB CODLER VALIDA ION � P Y provi.inns or tl:is QCcmedrevoF:rel. FVRNACE: FAU—GFlAVITY_._ L7Cg}�51:DCOVTIL\CTOF25DI[CLAFiA7'IbK FLOO�i� 6Tu_»> I herehy atfirm th�t I�m licensed un�irr�ro�'isions<�f Cha��tcr HEATLFs: SUSPENOGb UNIT 4 (cnmmrncing�vi�i�Secli��n 7000)��f[)i��isinn}r�t the A�si- V1ALL . nes�and Yrofessions Code.and mY license is in full force;md —��/�A��-/,(��M�`'^ /p�� ctf�c[. %i r/�� I!_� 1KV Licensc Numbcr I,ic.Class � � � Contractor Date � � 1 am esempt Trom thc licensing rcquiremants as 1 a� , _ _ � `��`-�'• ❑rens�d architect or o regis�rrcd pro£cssionat engine�r p�pn Check fee 25".0 of ebOve. � �' . . . e S` actinF in my {�rofcssion�l cap�city�(S�ctiun 70ci. EsuS --------- ---' ' . ��rs.�ad r�or�s,�<,�s c�a.•). PERMi7 1S5UING FEE S 8 �J �'1„�,(��-;� 1 /��J`(,1 .i: c`�� - I.ic.ur tcep.Nn. oetc ---- -----` TOTAl.FEE ` � AO\IF'O\1'i�Eft.F1U1LDL:Il DECLAILAIION P�APJ CHECK APPIICf.N7 t herzbp� affirm that 1 mm exempt from�the Con[rector's PJnnt[ � License Luw f��r tl�e fuilowing rca+un (S�ction 703I.5,il�si- — - nese and lkofessi<ms Code): .ALlDRE55 - � 1.as o���ncr oP tl�c pcapert>'..,�ill S��thc�•.ark and thc . xtructure i, ni�t in[en�ied �� of(ered f�r x:ile (S��ctiiin CITY TEL.NO. 7034.f3usiness and Profecsions Cnde). // — O:'1N E Rs{,(�.� � I,as o�vn�r of tlic prnjmrb'.am cxclusi.�rq�cuntractiny i V+G- ��/f�� . .vith licensed cont�aetnrs eo construet the {rtoject Mnt� � ) (Sectipn 7034.(3usinc,sand Profccsion.Codc). c,00�ES.^.�nj_��/Q��Q �N�Q!Y [� . COySTItUCT10hL1:t�UlhC',A[�I:VCI' CITY /_Ip�N✓?` T'" e�/91// . 1�/ / — 7 U 7' I hereb)� ofCinn thut thrre i� n nstructinn Irnding ageucp — —"-- - r�� u,r perfnrmance or u,r «��ti e��� �"i,�d, e��s v.•��,�� „ coraTnnc-/�;�' .m,orE_ T✓TivoG x�Je.� issued{Sac.3097.Civ.C.). —✓•- .� ' Lender's Nanie F�DDFIE�'� p /� ��/ ^t— o`1p_.�?-�p=W pLlil�/ Lender's ASdress i CITY � �� � TEL.N(SJ�O /�f Y�2 ' uST_ �� 6��6 1 eertify lhat 1 h�.'�re�d thic aL`I�lic:iti��n anJ xtat�tlt�t [he ,',TATE LIC. /J z^ . unovc in(ormatfon ic corrcc�.�aeree tu<omr�T«�cti au couo�>� ��,��cPN,P a"'�'�5�3�� clns^ [.. �� . nrdin�nccs and St�[r I����i reEut;�tinp Fir��inF.�'rntilatin;;�nJ Air Conditioning.and here6y authori�o represematives n[thi, 51-F RF:VF:RSF:fOR I�:XPLAM1.4Tpli�'LANGUAGE . . C�iunel' t� enter u(�nn th� pbo�e-mentiuni•A Prol`�rt>' fur Itl<�,t`c SP� �oy ,,� y,2 y�,� �.tw��� , Signaturr ,I l-ermit� tee p�te . �i� INSAECTOR'5 NOTES O11'\F.F-IIUIE.11�i:DLCLARATION 1 hcrct�y'affirm�.ihat�1 am e�empt[rorn[hc Ca.nt[actor's Licensc L�tir far ihr followin,t rcawn(Sraiorr iO3L5, ' � fJurLtcs.r mrd Frnfcssimu CoJeJr A�r}� d!}' or coia+n� _ ' � whirlr rrquirrs Q �C,41tlI m ror;stn�cr, cl7cr, intprorr, • . .'. . � . . , . _ � _ , drmoL:rlr.rr repcir m�y srnrrnuc.prior to irs r.r.rzmrxc, � , olro reqtdms tGc applicmrr for ar�dr pennit to filc c . , , ,� ' rigrted rto«�meur d�a! !te ic li;e�ued pursarmu ro rhe , . . . . pr�risions nf rGe Coatr���fo�:v License l.a.��(Chap:er 9 . . . � (cnnurieneb�g x�idi S'ectio�� iUUO/ nf Dirisiou 9�(�frr - F.<ctirtess' nnd P�uJessiuns Codr/ or diat (ie(s exernpt tG;reJrmn und die busis jor tlir affegrJ exenrpfion,An}' . � � �•rofatinrr of Sccti�nr 703/.5 hi'arn�npplirant fora prnnit � .. . . - � . .. srei�jreft t1�e npplirC�;t to a Ci��il pen�lrv oJrroJ more ti�r.i+ .� ' jice I+uirAmd dollars/5500).: , . ❑ 1.�s u��ncr of ihr properl} u�ill Jo ihc uurk,and . . Ilic sfructurt is nof intended or oftcred 1nr s�k. ' \ (Sec 70-0-1. Brrsiae,cr a�rd JSnjcc;inrv Code: T7rt Cwi- ''- ' - � . rraetnr's Lireiue 1 an�duer unr apPlp�o en oHvter uj , prop;rf)'�4'Aa b:�ifds nr i�npr�res d�er<�o�r,nid�o1io dora� � audr��oorb l:i�ntel! pr✓ri:leN rlmr vuch in�proreiucnrs � a�e uot iirrzuded nr ofJerrd f�r rcle. /j, /eo�rerer, tlre � LuildD+g or rrrr,��urrrrienr rr rold w�rtl:in oire vear of . mnrplelio�i. dre aivrrcr-brrlder wrl/ Aare dre trurdeir � .. . , nf prorrng tLa1 hc did rmt bu%!d ar inrprorc for dae — . . . . • . . ., �'\ '... , P:vpoac ojsatc./ � [�j I.as u�oncr nC Ihc prop:rtl�,am c�dusiccly ron� � [roctin�¢ith li:cn,_d cnNraclu�z to cunsiru:l tlre prujcet . (Section 7Q-0-t.Strtiness erid/'roftc�iorrs Code:The Cmr � lrcccor's Lrccrtsc l.mv rlocs not cppls' to an uwncr oJ . . , . properr}� itdro builds or inrJvoces dtereun, mrd �rlio cartra.��s for e�udr projects�rith u munoctor/rJ)rcc�trrd � ' � , � piernra+rt fo the Conve�ror`s�L irense I,aie). 1 am ezempi undcr Sec. I3&P.C.!or[his rra�un Date ' . . . Onncr �` ��- INSPECTOR'SNOTES . `�-��". -. .:�.�,�,,' . _ r' • _ ,�' � �' . . .. _., . . .��� �,,�� _