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1831A
,��ak�:as�����,��F;�s,,���hr�t�-�.:�a,�Tro�: 7GA3'u4C ,c �PLICATIOf�! FOR PERfr�IT [ hrrahy� affirm that I harz u certifics[e nf conaent tn s.if CE-87E(2EOi 1 � insurr,or a cec4ifi.�te of 1t'orkers'Cort;pensatirnn lr,surance,or HEATING-V ENTILATINGAIR CONDITIONING ' u certified m,( th^-� F(�4���,3800.La�b7.C.)��1 -{� � I'olic wP G:�1 3>S�r.��ltL�T1UN�1—_ � ' I ❑ Ccrtifird cupy rs h�r�•by furn�shrd. COUNTY OF LOS ANGELES BUI LDING AND SAFETY ��«,�,����, f,���,..;�.�9�l`1-� ��� �T 3 �'��� E�'�'�"t�°� FOR APPLICANTTO FILL IN F3UILDING a"o:'t ' �. no�aess ZS� CL�R C��—C.R� � Uate `��Applicant (PRINT OR TYPE ON�Y) LOCAUTY{�1/�{, A-G�� �q � C1:RTII'ICATL OI�LXl;�il'TIO�I�KO�I��'OItk:L,1;S' NO. I TVPE OF AFPLIANC[OFi E�UIPMENT FEE I.J1L'�L�� CO�.1PF\SATIOh INSUR:�NCI( NEAREST } ' (Th15 SCction fiCC� not h� COmp�c[ctl IS thc �t'ork involvcd jAl'�OFtFTION UNIT,6TU CROSS ST. O � �l}' <<1C PC[IRI[ IS �Ui Otll` �Illll�ft't� (�0��3tS (5���) OL �l`SS.� �ISTHICTNO. PPOCESSEDBV (� � I eer[ify th�t in thr perf�irm�nce of[he���i�rk}iir�•:liich[I;i.; i�11F Hl�NOL.ING UNIT,CFM permit is issued.I shali nnt emplu5 any ptrs��n in any�n:snner 'O � so as[o becumc subjcct tn thr ' '.crs'C<�n- •nsa'�.m Lsvs. I E301LE R,F.TU /'� APPROVALS �ATE INSPECT 'S SIC /.TURE � Uate _\p�+li<ant _ _ _ . •__ _I�iCOA7i'RESSOR.ETU�•� �Iv O� ROUGH o� a', Y � y N� `I:�fO ANI'LICANT: It,a([��r m::F'.in��thiti<'�r[ifi�;itr n( I��ENTILATION SYSTEM I / `�, z l�:x, ,�tion. ynu 51�eiuid hec<�me s�l�J�`tt to tlic 1t'nrArrc' FINAL - Compensation pruvidons of thc Lu6nr Code.Y��u must f�,rfh. � wi�n com�ly witn suen �rov;.s;�,ns or cn�; �ermrt sn�n r� IEVAPOFiATIVL COOLER V UDATION deemcA re�'nAeJ. � `FURNACE: FAU���.�-U:�— �� (� LI(;1:151:f)C'UNTItACTOItS UI:C'I.AI�ATIO\ FLOO(1� E3TU f_LJJ 1 hcrchy affirm it:at 1�m liernsecl uncl��r�rr���'icirin,o((ha{�trr F�{�qTEfi: SUSPEND[D UNIT 9 (tommencing a-ith Sectian'000)of Diri;iun J ot the 6usi- WALL ness and Prnfessinns Code,!a�nd my liccnsc iv in full f��rce and ,^ 1� t T� �,� rv�-1 S.O effect. �j2.C.90'�1(O C-2�_ -�V 1�VL-`1—�'�..�J�`.��5 � Litcnse NumUrr Lic.Closv_ � � I`�� . Conlrac�or��ll�l���N D�tr 2'Z_I_8� I . � � 1 am exempt from [he lice�ning reGuiremrnts as 1�rc,a � �fcensed arenitect < a n;dsn�red protcssuna� emdnrcr Plan check fr.e 25°�of above. � - acting in my profcssion,d capucity (Sectinn 7051, llus- iness and Prof�ssions Coda). PERMIT ISSUING FEE$ l� SO Lic.ortt��;.N<,. u��r TOTALFEE � �V ti0\1Ii OR'\I:R�OI%ILUI?R DGCI.AP.ATIOV p�qy CIiECK APPLICANT I hereby affirm [hat I um c�empt fre�m�tlie C'�>ntr;�ct�.r's NAA1E l�ce L�w fur the follu«�inc reuson (Sectinn :03I.5, 6usi- r id 1'rn(es�ii�ns('��d,:): ADDRESS - [J �, �s ��„��•r �c u,� �«��«n.���u a�, w�•�;���� :,�e tF.e CITY TEL.NO. �1 83 1 A shuc[urr is not intended ur uHcred fur salr (Sreti m 7043,�urinesc;ind PruTrscinnc Cndc). � . � 1,as o��ner ot[he ro OWNEFI���-.^�`,^ ^`�/ . � p C�'rty.�m exdusivcly eontr�c[iny v-1 IVLJ./ Y �• • • • •8 �vith liccnce� ���ntr:i��tors lo cc�ns[ru�t tlic �rnjcct MAIL o (Section 7DlJ,E3usincss uncl I'ralrstiions(:�dr). nDn�F^`�coc��oWN'�`_COUNSLz .r.• •4 p Q Q ' CITY TEL.NO. ,� �'e = covsr�<uc�iov L�.vuir:c,acn ncr Q{Z/�NC,-�C , 4 8.0 D� I hereby aflinn [ha� Ihrre i s cun5truction landing��.�.�,�,� Wp�R[Z�Sc�N—ki�a.� ��0� 8.4 for Ilic p�rfurnt�nCe of ihel��'orA f�ir ��I�icl� Ihii F�err�i[ ii CONTFiACTOFt y � issued(Sec.J09^„Civ.G). ' , Lender's hame _ F.DDfIE�� �� I.�gc��3L."71�OR Lendrr's Address CITY TEL.NO. � � _ aHl._� 1 ecr[ify that 1 haec reaA thi;a�•plicati�in and s[a[c tliat Ihe abo��c in(ormution is currcc[.I aErcc t�>c��mrl)'n�ich all C�ur�ty STCFfh�F NCf.��3� CLnSS ���� ordinancer nnd Sivtr Isu�s rrl'��latine lfcaiin�.\'rntilating and Air Conditioning,and herc6y au[hori�e representative.ut this SF:E'KI�.VF:RSh:I�OR I?XVI,AN.ATORti'LANCLiAGI-: Cou to �m��r ,mi he abovr�mentiu��cd propan5' I'ur ���,s�� � 2-2q-84 � Signafurcu(IYrmil[ee Dstc . . INSPcCTOF'S PdOTES � � >>�,�,�,�rr.-:,t�r[.�;�:�:li�cLr,i:�.�rto?: ' . - � . , _ 1�Lc'cb�aFfirn,'li.ot 1�nm c�cmpi(ror^theContrncror's Licensa L:�.c. (i�� Ih• lol:ou�ing ruas��n �Seetion 7031.J, , . � '- �• - � G�c;iiics m;:t !'rof�:ssiorrs Cod.J: .t�n� rity o; courr!)� � v;rlrh vr^:urr; a.p:�mir !o constr.�cf. clrcr. improrr„ � . .� � , . , . -!, � . , d�vr;oli��h. [ir/:�;�,^.ir'Cav�^ .�rtt�rF.Pri�r!O i:s i,suc�(ce. alsn�rrqtrbrs ti:c u;•^;icm(r fnr s�Ni permit`m fele c , -"�'' • � � . .. � . , . si:ned sm�cr,!cr.t�d:�: hc is !ic�nscrl pars:+���t fo ll�c pmririnr:e uf 1l;r ('u����nctor's I.iiciise f.a�r((7;apte�9 (rcn�r:c,i-i•.: i��itS Svrtirnr i000J nf Diris!:.ur 3 al tLe . � f,la�ii^sr u;�.! f7�of�s�rw�s Cnd_J or diat Lc i: Cxemp[ , tirircfroni c.�rd tl�c barie fo�d�.affcgtd cxCir:p�(iorr.iS�rY . . � vio(atin�i o(Sectiur, 7C31.P ub'ei!1'a(�plia:n�fora pernut . , .. . � .- , . . . suLjrcls Ni.c��;:!irn::t tc o ciri!panafrc of not more thcrt fi.•l:�: 15'���,.::-51S:On� • . ,. �[]���. .._�o'�;:c;�n per[}'�ri!!tlo�ire•t.c.rF�.��nd _. . • ... . • tha strcciv:,�is n��:i:it:m::d or otfcrcd(or sal_. i� . � (Src. TO-1d. f��+..:;rn:u;:! f'r'nfzssior.c Codr: T1ic � � l��cc7nr's J,i<rrrrr /c�r: does ��✓f appfl' to m� oKv�er of � prnperrt� r:i�u hui1�L nr i�r{?rora�N:erca�.arid w&o da:: sa�cl: ����i;l, l;�nurlf J�rurid;d !l;at suCL iniprorcrrtci�ts - . .-, � . arc r:of i��(<'r.dd-f nr offa�ed for ra!a !f, liomn•er. dic bui�]ir.:{ ur im;�ru��ic�,rN is sa'J �+'i:!ifu w�e pra.- of ca�rp'ctio;r. Ii�,' uirr..rvLic!dzr tc!(1 l:mr thc Lurde�i of p�rorbr;� di�:� l:e did not baild o�ir�Pr'ore fur dte ' , -. � . _ . � . • . . . . _ yitrpnscnf.tJlr.J . . _ � Q�:�a;o��.:��a;ui lLr Itropc�t�:am.e�clusivciy ron- tract,;.��itl�I��ccr...d n�ntr._[ors tC,conitn:ct tho project - lS,'crfo�: ;u�:.6�.,i•r�ss cr.d/roir,}�!���Co9c:The Car� trectnri I.i:nrs� I.n:r doe.c not app(y to ar, u•..�ner of , �vuprr�y �ch.� L�_ii(.is or i�e�vnrer ll;erenn. errd i:�ho . co+:rracn j��r ss:�!� pr„/r�t.r�:irh e conrmctur(rJ licensed . . � • p:enue;u fa i4r(biin-,:r(ur'sl.ir�•rs.•La�rf_ . _ � I am e�cripi unt9cr 5�c. L'�i C.C.for titic rzm.n�i — r-- � i l�ate—_ Oc,iier 'IP,157ECTOR'S NOTES � � � � • � � ' � �