HomeMy WebLinkAbout1500A (8)V, 0 R KI, kJ'CO%lP '� NIII ON I)L( LAR A I N'
IO
I :I affirm Wal I Inn,(,f C -'—'t to SQlf
or a C—rm at'- of 0-1
-C tlfiaJ . C.)
Percy Nr,. coral-uny
F1 certified copy i, hereby tarni:hcd.
F-1 cc ifi,-j f 1,, 1 ,it h the-,• —.r.t I I uIld mli inLr,,tii
del t nl-t.
Dat,— Appli-aort
—
CERTII LCAT! (H r TION I PO)l N1. 01LEERS'
COMEI:NS VI ION INSURAN'AE.
(Thi, set on —11111 not I',
by I I ple, i t k rl,, 0, - Irlr r V t2oll... (SIl ,, 1,,,.)
I —litEl- I! i,i tlI f I of Ili, t 1- ,Iflgh thi,
Paan it I 'j"til jI)t 'R'111P("' m:i, nr. c
sn it, tz
V—rl I
NOTICE 10 A ' '13',AN F: 11, aft,, this
F-mpti, y,I,! , h'nuld h, —il, ��',jc,t t,, the V—r I.: , f
Compensation r -'mo." of it;, I 'T nr Cod", 'n't —wfi�'T
-
1'-O,in0 i, gp—iit shalt
,I be
CON 1 A IZATION
I["—b� zifl th it I I!,1 I—n-1 ender p, -M—, of Clhap:c,
9 --'r "i'll pi'ri'jL," -,I of th' B3 j.
ness J Prof ... in-, i, iR full f'i"' and
cele ct.
Cont,otor-- J),j•.
❑ I ani exempt tr(,Tn the li—,sin, as I an 0
(iccnseda J""f—io"A -gin—
lil., 31 (Sem— 7051, rl—
i-" and P-fi .....
Lk, or Ret.. Ni-- D,t,
HOMEOV"NER Mill,I)Lk DECLARATION
Iarri"�l III't I am1-m the
I'i I - for the 7031.5, Du'i
r of the
11', —k -d theIt I_, i, 1 1" 1 1 1 < offcrcd for ,I, (Section
7044, r—in— a,,1 Prof—i.— C-1,).
of the in,
,with rli:.cnsed —W—tor, to --t—t the E -j -t
44, U.,w— :!.,,I (",,d,)
CONSI R[ C-1 ION LI NWNG A<,VNCY
11,3t there 1' iL lli.lt—ti—
for the perfnnn:,nce of th, I—irl, f- Ihidh this j—R,it i,
ucd (Sec. i3097,Citi. C.)
Lend,,',
Lender's r\A caress
ante tll3t I I,,— —'! 111i, jpr!i:�iti-I allandntc that the
al, L' m f"_,�' ti _ i, -,—t. I to -mpl, ,ill, 111 co—t)
O'd m—
a1 ..�"I ..... l"", "pflAi.; Ventilating and
"d
fi.,
Ai, C—diRi,,, z,-1 jherebyth-- if this
C -.'t5 to enter up'- th--
V 10,
I
s � �' Rai'gw
wr' Mf Pz"'ittLc Date
A3
7 C' C4C
CE -818 (2130) APPLICATION FOR PERMIT
HEATING -VENTILATING -AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT
p PLICANTTO FILL IN
(PRINT OR TYPE ONLY)
LOCALITY
NO.
jTYPE .1APPLIANCE .REQUIPMENT FEE
NEAREST
A11S..PT1.11 UNIT, BTU
CROSS ST.
DISTRICT NO,
F ESSED By
AIR HANDLING UNIT, CFM
SOILF R, DTU—
APPROVALS
DATE IIISPECT.—,IlINATlnlj
compRrsson' BTU -
ROUGH
VENTILATION SYSTEM
FINAL
'EVAPORATIVE COOLER
VALIDATION
FAU— GRAVITY—
FURNACIE:
LoOBT
HEATER: SUSPENDED UNIT
WALL
Plan check fee 2545 of above.
PERMIT ISSUING FEE S
TOTAL FEE p
II
1 5 Q 0 A
PLAN CHECK APPLICANT
8
NAME
-30.50
ADDRESS
•.3 0 5 G 31.
CITY TEL. NO.
02 13=84
OWNER
AIL
A .."ESS
T
CITY
CONTRACTOR
ADDRESS
CITY TEL. NO�
STATF. LIC,
LICFN�',F- NO. CLASS
SEF FEVERSE FOR EXPLANATORY LANGUAGE
I
w-
INSPECTOR'S NOTES
OWNER -BUILDER DFCLARATION
i hereb}' affirm that 1 am c—pt from the Contrector's
License Law for the following reason (Section 7031.5.
ll:rsiners and LYofessions Code): Atty rift• or count
idrich rrquires a p.rmil to ConrtrVet alter, !nprove.
repair run stn:cu+rc, prior to its i.-su.txite.
rlso regw cs the app!!canr for such le -unit to file a
- - - i(7ncd statement r!trt he is licensed purstiat to rhe
provisions of the Contractor's' License Law /Chapter 9
(commcnci.er; with Sectirm 7000) of Division 3 of the
JJusinesr and Professions Codd or that he is exempt
rh refrom a^d the b,asir for the albecd exemption. AnI
violation of Section ,0315 br any r.•nplicmn fnra pe mlt
- sntbjcrr.s tar. cppliccnl to a civil p�ncalp• of nor more Than
fire Lundrrd dollars
❑ 1. as owner if tho p ol—ty will do tl e ,ori,. and
tl.r structure ie out intendeJ or ufiered fur tale.
(Sec•. 7044, Bus! ss and Pmfeadonr Code: The Corr
iractor's License Leve docs not apply to at owns of
propery it -fro bu141s or it ip—t es thereon, mrd giro docs
such wori, himself proikkw that such inrprovenrews
are not i+ucirded or offered for sale. If, hot,rrer, the
baildinq or i n:peorcmenr is sold ivitl,in on,, rear of
completion, the owner-b:rllder i%•ill lata' the burdrrr
of provin,; thot he did not build or iinrprove for the
pupvrse ofssle.)
❑ I, as oi•. nee of the property', aur u,elusNc!v con-
tractm, isitI% liccmet! cu ntracI ors to construct thio prq cct
(Section 7014, Ra-wnr and 1'rafessinns Code: Th, 61".
trartor's Licct:sc Lav docs not appb• to an owner of
propm), n1i builds or friprovcs Morcoo, and who
corrlrarls for such projocts t:irhecontrr,tor(i) licensed
pur�rmn!
to tic Co:lrarturS License
1 ant cNerupt tinder Sec.
B & P.C. for this reason
I Date
Oiancr_
i
INSPECTOR'S NOTES
• i