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HomeMy WebLinkAbout1037A \L�ORKI�:HSCO`dl'1(VS:\TIOVI)fCL:\It:\IION CEa-810(2�80) APPLICATION FOR PERMIT 1 hrrehy affirm Ih�t f hacc :f crrtificate nf tonsen� to self ; � insurc,n�scertitic�tantl4'��rAcrs'Compen5ationinsurance,oi i HEATING•VENTILATING-AIR CONDITIONING :,�e�rr�e�tc��>u,e,��r�se�.�Rao,i.,r..c.) ' p615-2.-13 ,,,,,;�y.1,L014-.11�.�,m�,�s. Paci.fic Comp_ � DZAMOND BAR ❑ ccrtiPi��d cnpy�s hrrcny furni>!��•d. �I/� COUNTV OF LOS ANGELES EiUI LDING AND SAFETY o< � I'e tified ro�y is filed xi�h ihe rountr huildinq insprctinn� i Bl11LDING ' ,�..�1,/,.„�, �, b i FOR APPLICANT TO FILL IN Aoortess N. n1gIDOIld—$1�d-. Uate�v���((/��r��<����iaL:�Temp (PRINT OFi TYPE ONLY) IOCALITY CIiRTIPlI'ATE OI'£.XL!�1PTlOV CROV«'OR3CGRS' - NO. TYPE OF APPLIANCE OR EQUIPMENT FEE niamoncLBar CO"dl'LtiS.\TIDN I\SURA.'QGi i NEAREST } CROSS ST. (This srction necd nnt be completed if the �vark im•olved AOSORPTION UNIT,FiTU a by thc permit is for onc hundrrd dollars (5100)m Iess.) D�STRILTNO. � vnocesse av V 1 eertify th�et in the prrformani�r�if Ihe work fnr�ahich this i !+�R HANDLING UNIT,CFM /O � permit is issued,1 chall not e:nplu>�any per<nn in sny manner I �� � xo:ic to becnme suhiect tn tha\C��rkrrs'Comprnsation La�vs. AOILER,(ITU MPROVAIS D TE INSOECTo 'SSIGN4TUAE V Detc .App�itant�� COh1PRE5SOR.OTU W ROUGH �/ N NOTICE TO APPLIC:�YT: ff,aher m�kinG this Certificate nf VENTILATION SYSTEh1 FINAL ? l:rem{+tinn, ynu shouii7 hrc��mr +uhj�i�� t�� the �l"nr4:ers' ' — Cumpensation prnvi�iuns of the L:J�nr Code,ynu mus[torth- EVaPORATIVE COOLEFi /AI�� A N �cith comply n�ith such P����'isions or thic perr�it shall be deemr,d rr�•��F:rd. FUFNACE: FAU—GFAVITV [.1!'lCXS['.p CD�TR.\CTORS�IiCL.1R.1T10N FLOCfi: BTU 1 herchy a(firm Ih:it 1�+m li;en�ed undcr pr��}�isions of Ch�pter I HEATER: SUSPENDED UNIT o (rnmmencinq�vilh Srctinn 7000)�f Di��i�ion 3 nf Ihe ltusi� LVALL ness anJ i'rofr:sinnc CuJr.snd my Iicrns��is in fuil fotce and . � �'� (� �''y(j . . . . . .. effrct. � _O_�'�� y—�� Licence����n�,,,r_231640 Lic.Class C'�� I , Dial-A-Temp I � cnntr_ct„r f>�,te_ / ( ❑ ��( f���J � 1 am exempt (rmn Ihe licensing reyuirements:s I am a licenscd architcct ur e rrgi�trrtd prottcsinnal encineer I Plan check fee 25`?0 of above. �ctino in rny prqfr,�inn��l caparitp (Scction 7051. Ftus- I � . ineca:md Prote�.inn�Codr). ! PERMIT ISSUING FEE S �„� ,q,i n�.J Y Lic.or Itec.Nn. Uatc j TOTAL FEE ,j� ' '�i•:+3�2�5� � � IIO\1TS O«'tii;R�il1ilLll�i2➢iPCI.ARATIOti � pLAN CH[CK APPLICANT ���� �3'z 5�0� l hrreby af(irm that I :�m eermpt Gom�the Cnn[nc�nr's � NAME � I 2� 6�A'� Licence L,�w fnr!he (nllmcing rca�nn (Sretion 7033.5, n�5�- . Dial-A-�Tem Z71C. • � - P�— nrss and 1'rnfec�innc Cndc): , A�ORESS " 6�aunta:i.n-14ay •J i. as ou�nrr of tix properc5.�4�iii un iirc�cark ami tiir ' CITY TEL.NO. structurr i. nut inten�leJ or offered for s:ile �s����<�� ; �Anahei:m �3�-666L1- 79�4.1)u�inrc�nnA 1'mfe«inns Cnde). . ❑ � OIYNER pace 1,as mvnrr of lhc praperi5'.�^� e<clu�irely cnNncling wilh licen<eJ cn�itructurs tn construct ihe prnject M17AIL � (Sectinn 707a,I1itSif:C55:�f1cl I'�n(�•sci<irs CoJr). ' � nooness 180.5� E, Garry� St� #IIQ COVSTRUCTIOV LF:NUWG AGI:4C1' CITY Santa Ana TEL.NO. 1 hereb3' �ffirm tlut thrre is a cumtrucfiun Irnding aerncy , _ for the perform�nre nf the �cor4; tnr a�hich Ihis permit is CONTRACTOR ;ts�,ra�sc�.3on�,c��•.c.�. Dia1--A=Temp I.CIItII`l�51:II11C ADDfiESS S�TE . - Lender's Addreu . CITY SAhtE TEL.NO.SAME . ' . • 1 certifY ih:�t I IIJ\'2 re;iil ihic a�+plic�tion an� st�te th�[ the ', gTATE gZ231640 LIC. . aho��e in(nrm�tinn is rnrrect.1 JerC21n enmrl)���'i�h;�II(ount}• ��. LICENSF.NO. 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