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HomeMy WebLinkAbout1829A ,tioa�:r:r.s�co�,r,:xs:�„o�:ni:ci.nii.�T,on �E``8;°�z.em /�,PPLIC,�,TIOfi� FOR PCRR�II�i ' 1 hrreby af(irm thst I hncc a'cenificu[e af cn�ucnt to sclf , � insure,orace.itie�teof�vorkers'Compens:�t�nnlnsur.mee.or HEATI�iG-VENTILATING-AIR CONDITIONING a cert(ie� cn i th f5.�c 3800,Lab.('.) ���,����,���t��sa„�—F_Ret�n��1T i' � CertifirS cupr is herchg furnishcl. ��!- �a�N 40F LOS ANGELES BUILDING AN�SAFETY w n � �Ccr[ified c�,p}�I.file�t��i(h u y�h� Idin�ins�rc[i��n � 6UILDING 1�1L C�((�, a,��arr r Q FOR APPLICANT TO FILL IN Aportess�2�C. CLL,��__ _ I)�te?���lAp�+licant����� IPRINT OF TVPE ON�Y) - LOCALITV��A�� �R Cl:RT111CATE:OI�I:XL:M1:1'TION I'ItO.":11�'p121�f;1.S' NO. TYPE OF APPLIANCE OFi[QUIPMENT FEF. Cp\tl'L;NS:\TIOV lYSU12ANC1. -- NEAREST } (Thl< SCCitOn nCC� nUI �)C COm��e[ltl If Ihl u'oIL: In�'olv^tl ABSOFtPTION UNIT,6TU CF;OSS 5T. G. by lhc permit ic (or unc Imndred dollu�s (SIOD) or IcssJ � oisrnicrNo vnocesseoev V [ccr[iCy tt�:�t in the ���rform:ince nf the w<�rk fr�r�shi�l�tlii� iAIR HANDLING UNIT.CFP.1 O � permi[is issued.1 shdl nut empluy ar,l'P�•rson in an>'manner � su u.�'�e�becunle suhjucl���tli- rAe 'C�..{�cn��tiun La�vs. �OILER,6TU _ I - � F- /� APPROVALS �ATE INSPECTDR'SSIGNPTUfiE � U DaTC�PPlican[ ._—_. —3. � COM?RESSOR e7U C.•� '� �r'i 04') .—._ — , �Wa `� ROUGH N(1�11;TO.V'PI.IC:\N7�:It.�fter makine[hi,Ccrtific:rtr of - � N VENTILATIONSYSTEhi I �� i� Z f:r. ,iun, you sliuul� hec��me suhj�ct t�� the \';i�rV:ers' FINF�L Compensutinn prnvisiuns of Ihc Lahor Codc,you muet furlh- . w'i�h i•nm�ly with sucl� Provi}inn.s ��r this p�rmit sl�:�tl �.� EVAPORATIVE COOLEit I ,!A aT� IV deemecl rr�n};i�, FURNACE: FAU q�y� � � LICI:i�'SLDCOtiTItACT01:5[11:CLARATIOV � FLOOR: BT�..��"_ 0� . ' . . � I hereby affirm tha[I am licensed unJ.r�+r���-isionsof Cha{�.ter HEATEFt� SUSPEND[D UNIT 9 (commzncin�s��ifh Scrti<�n 7000)of I)ii�is'inn J ot[lie B��si- V�'AL� , �, ness und Prnfessians Cudc,and m>�licrnsc is in full(orcc and �`��`�s�.N,,,n9�322�a-�ico�,�.��:,,�c_2c� �o Ncs:._-�s�crJZL�.Ls s� <<,�,�������}�l�.R_R��S��>�,��_Zg-v�— @��'�S , � [am caempl from [ha licensinr;reyuiremrnts as 1 arn a licensed arcLitect e�r a re,iscered profcssional rnginrer Plen CheCk fee 25",0 oP B6ove. aetim� in my profecsional eap�cif�� (Scctiun 7051. Bus- in�ss�n;f��rotessions cndi�). PERMIT ISSUING FEE$ f�St� t.ic.or�t�g.N��. [��tc _ TOTAL FEE 48 � . I10\If:O`\NL:I:�BUI[.[)I:R I)I:CLAI2ATIOh ' pLAN CHECK APf'LICF.NT R 1 8 2 9 A I hcnby affirm [hat ( um esempt (rom�the Contractor's NqME . �• • • �+8 nsc Law fur Ihc fulln�ving re�sun (Scction^OJLS, C7usi- ' � e i 4soo 'a�cl 1'r<�f�.csiuiis Cou�•): � ADDRE55 . • • � 1. as ou�nor of[he prnperq�.�eill dn the u�ork and Ihe 4�O O U s[ruc[ure is nut intended or uffued for saie (Section CITV T[L.NO. •+e a 7043,I3usinrs..and Pr<,a��.,�„n.,a�a�>. ��/�, 0 3,O 1=8 4 ❑ OWNERC rv7`�t A 1�1� ���!- .. I.as o�aner uf[he properq',am escl;isively cuntractin5 ..71.1�- �V . �vitli Iiccnsel eontr�etnrs to ennctruct Ihc �rrolz�'t A'IAIL f . (s�cc����oaa,nu.�n�•.l��a��r<�relsion.cod��>. AooaEss g(�=]tj��/����(�j�'R� CITV�(� An1C�� TEL.NO. CONtiTRUCTlO�LL:NUIV(;qGP:NC1" 1���V v ] lierel,y� �ffirrn [li,it Ihrre i.i � cunstructian Iending u�:<ncy CONTRACTOFl fur thr per(ormance f thr nurk fur actiich �I:is Ptrmic is 1-I,A(ZR1�:r�1—H_t'G. .. . . . issued(Scc.3097,Civ.C.). . Lender's Kome — ADOftESS g9�_TS�.TMoR . . Lrnder'sAddress . CITY �EL.NO. , ' � ��«,� ,��:,< <h�.����.,� ��,,. —ANAf��.IN� Y apPticatiun and state that the (^ ab�»r in(<�Ima[ion f+ctilfcc[.1��rc��t�i c m�il}'u�i[h.ill C'ounl}' L.TCENSE NO.��3�5�.+ CLASS �,��� . . . ordinancrs anJ S[ate la�vs r �ulating Hrating.Vrntilating and Air Conditionine.and hereby�authnri�e reprexntu[ices uf this SRI?RI:VI{RSE 1'O}L 1:Xf'L?.NATOIi}'L7.NGUqGI: . . C > to t p the aboce�mentiuneJ 1'rupertY fur - ',r :�����•�rlY� 2-29-84 Signature of� ll�[e � INSPECTOR'S NOTES OR'NEI:-IsU1LUER DECL�U:A i ION � , . ,1 hcreb}'afCirm�Lst 1 ar.i c�cmpt from thc Contrac[oc's � . _ Licer.se La�v Cu: U',e follo�vin�reauin(Sectiu�t 7C3I.5, �"" � ' '" � - � ' lTusirress er.d fYnfessions CudeJ: Anv ei�y or ro+uuy � ', ' � . � ickiclr requrrer c.pennf� to ronvtr.�et, alrer. irn;rore,:� � - � - '' -' � '- ' detnolesli.�n�,rcpcir.,nr�l,'s:nicfure,priOr.M its issucuce, � � � also requires ikc ap/>Iiccrti�for sudi pcnnr��to fifc a ' - . . . . -. -. srgn.rd smtemcrs7 diat &c is licerr.ccd parr+mnt to 11re � prori.rions af fiee ('witrnt�or's Liccrtse IeN;/Chapte�9 (conunencin; v:rth Scctiai 70001 nf Dirision 3 oj 1He � R¢si�ress end Frufcssinr:s CodrJ w thet !rc ie� escrnpt � . 1he�efrorrt end du haris for Uie cR.lcd exent/�fion.�9nr , � � ri�ilc�iuit tif Serfiorr 7(.'3f.S hr aitt'cppliccnl fara ptrmrr • . Subjeclt dte nppliean.r to a�iri!pci�clq•nf not nrore lfiat! fire GunJrcd'Jo!!an(SSODJ.:� . ' ., ,.. .- � ❑ I.::is p�ti;cr��f thc�pru,crty��ill J�i�tl�c�curk..anJ . . � tLc structurc is no;intcndcd ur uflcrcd for salc. ----, . � ,� (Sec. i011, 13usrncsr mid frojrssianr Codr: 7'!ic - ,. tiarror's Litcr�rc l.cic dacs ++a applv 10 cn u�cn�r aj pronrrp�wlro builds or inrp�ores rlicreon.and xho dues suclr �cord fiinself prorided d�at s:�ch irnprnrernenrs '' ._. - - -., . ' are r.ot lntended or nffi�red for snle. !f. ho�rcrcr. �kr burldirrg or irnprorenitnt is sold +erd;i�r are year of complerim�, rGe nwr.cr�b,;rlder u�i!! h,7rr tLe burden <,r�.o���,�,s t1�n[ lir did nor burld or L:y�rurc Jor rhr � . _ i_.-._ � �.+... �. '. ' ' -. ' . prrq�osc of aalc.l �,�.. . .� � ,: � ' �-Irus owmcr of thc�Firo�crij'.ntn c�clusivcly cnn- . .- , . .._. Irac�inR�tiih liccnscd contxac�occ tu rnns[mct tLc pmjcct (Ser�iou 70Ja,Rusi�i�ss ai;d'1'roJcssicr.r Ciidci Thr Coit� . — rrnrtori f.ice�rsc Lair dac,r rmr apptv to art oivncr of proper7�' �r1io hui&1; or inrprores tf�creon, crrd who corirmctr jnr sud� p�njrccs�citlr a eaitracro�(sJ liccresed `- �� ... � pensumit to�he Cu!rrrr.ctor'c Lirense l.mr/. ' ' . 1 am exempt enuer Sec. ' ' ' 6 fi P.C,fnr this reason � � �r, - U�atc � _ O�vncr '�. INSPECTOR'S NOTES ������ � � ' � � � �•'�' :��� . �