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HomeMy WebLinkAbout1115A , �+�oH�;E:es•co�irt:Nsn-r�oxnLct,�rtnT�oN 's"3G4C /�PPLIC�ATIOf�I FOR PER�IT I hereLy ai(irm that 1 hare a'eerlificatc of consent to self CE-819 12�801 � insute,oracertificateotNorkers'C�mpensstionlnsurance,or �'IEA'1'ING-VENTILATING-AIR C�NDITIONING „�a ccrtified cnpy[hereof(Sec.3800,Lab.C.) . Yol�c�No. Compun� RepubllC Indem. ' � ❑ Cert�tird copy is hereby�furnished. COUfdTY OF LOS ANGELES BUILDING AND SAFETY � Certifled enpq is filed with�he couniy building inspection - FOR APPLICANT TO FILL W cu��olNG �e,,�,,�me„�.,, • aoonE�s 23601 E__Falcon View Uate�L_ZSL��npp�+cant AL1S0 Ali (PRINT OFl TVPC ONLVI LOCAUTY CiSR7IPICATC 0['EXI;DIPTIO''7!'R0�11VORREkS' NO. 7YPE OF ACPLtANCE OR EQUIPMENT FEE Diamond_BAr, CA CO]1PLNSATION 19SURANCI: NEAREST } (This SeClion need no[ 6e eomplCtCd if tLe wprk Im'Olved AEiSORP710N UNIT,6TU CROSS ST. a O by t6e permit is for one hundred dollars (5100)ar IcssJ DISTFliCT ND. FRpCE55ED B� U [certify that 'n the per(ormance o(lhe x�urk for«-liich this AIR HANDLING UNIT,CFht . {Y� permit is issued.1 shall nnt empioy uny persun in any manner - O � 1 ,�lon e. O so as tn hecome subject to thc 1VorAers'Compensation laws. bO��Efi,[�TU — � MPf{OVALS DA7E �NSVECT n S'.GNANaE W u:,te AFP�icant �. COMfRE550R,BTU��V OOO 10 00 – - r__._ — ROUGH �Z— _ tail NUTIC3i TO AYNLICANT:1L after making this CCrtificJiC of VENTILATION SYSTEM � � ? l:xemption, you sl�iould hecome subject to the \Vorkers' FINAL _ Campensation ptm�itions of the Lahor Code,you must forth- EVAPORATIVE COOLER . � VALIDP�TION with comD�S' with such provisions ur this permit shatl be , deemed revohed.� FUFlNACE: FAU X_C,�Fl�j, �z Y� I . UCENSFCDCONTRAC70IiSDECLARAT]ON �. FLODFt BTU_L{[S�l,1�U.—_ 1�J�� , ' I hereby af(irm that I am licensed undet proviiions of Chapter HEATER: SUSPENDE� UNI7 � ' 9 (commencing wi�h Seceion 7000)of Uivision 3 ot[hr Flusi- WALL ness and Profresi�ms CoJr,end my license is in fu�l fortt and � � errr�c. ��nc 6 inlet outlet 1.75�� 9�D � —�_2�_ --�—--. �f.icensc Numbcr�Slll�S_ Llc.Class � � `' 8L25L87 L'ontractor�ll$Q�1T_ Datc_ . ' � O��1 am exempt from[he licensing reyuircments as 1 am� � � � z i 1 1.5 �� � Lcensed architect or n registereA protessional engineer Pl�n ChCCk fCe 25°o O�Abo'dC. . ��� � � '� atting in my professional ��r��iq• (s�cc;on vos�, o„s- pERPAIT ISSUING FEE S � 1 • `4�•�� � inets und Professions Code). � 1�,��_ �. � Lic.or Keg.No. Datr TOTAL FEE Q],.pp , • 6 •4�'Q�� HO}1L OLL'NCIL�[3UILDER DI;CLAILATION pLAN CHECK AFPLICANT � , . O S.P 7�H I � 1�hereby aCfirm that I am e<empt (rom�Lhe Con�fac�or�s NAh7E A11S0 Air — Air Cond_& Heating . l.itense Law fur the followinX reason (Secti��n 7037.5,Rusi� , ness and Nrofrssions Code): ADDRESS2�3�Z�IadfS.Q�Rd._,_IIni�C � � 1,as o�vner of Ihe proparty,wiil So the x�ork and the TEL.NO � � struc[ure is not intended o� offered for sale (Section CITY 11SSlOR Viejo_,_CA�951-1266— . ' 70�4,IIusiness ond F'rotessions Ctidt). . ' , � OWNER Nelson�onst=uction � 1,as ownar of the property,am exclusively con�rac[ing x�i[h licensed contr�eto�s to construct the projec� AD�RESS 5072 Grandview � (Section 7044,Bosiness and Professions Cude). . � CONSTRUCTIOV LENUING AG1iNCY C�TY Yorba Linda� ri/� TEL.NO. ', 1 hrreby utfirm th�t [herc is a construetion lending aS�'nc}� CONTRACTOR � � ' � for the performante of the a�ork (or w�Lich this prrmit is l�1.150 Air – Air Cond. se fTC'H . . � , � issued(Sec.3097,C«'.C.). . . Lender's Namr ADORE55 23342 Madero Rd:, Unit C � � Lender's Addresx C�T� [�1SS10R V12�O� CATE'-."o.g51_1266 � � I cer[ify thui I ha�e re�d this a���iicutiun anJ state that 16e STATE LIC. � ,, � abave infnrm�tion i;correct,1 aKrce to c��m�ily�.�ith all Cuunty LICFNSF N(l. �{0672.E) CI.A�S �Q . ordinanccs ilil(I S[JIC la�+�s rcgulatin�:}9e�tin6.�'entita[ing und � Air Conditioning,and I�ereby�auth�rire represen�atives af this SCE RI:VFiRSG I'UK I'XPLANATORI'I.ANGl1ACf! �� , � � County to rnie� upon thc �bu}•e-mentiuned propertP Coc . � • iucp :t'.�purpose. ' /� [� . _. . .. 1.5,� C�"c35-�i'7_ Signature o(f'ermi[tee Uate . . . '. � • - � - � � � - . INSPECTOR'S NOTES � ' , � , - 015'NTiR-PUILDEFL DEiLAP.AT10\ � - , . - ' - �1 hcrebl'affirm tl�al I am e�empt Croin�I�eContrac[or's License La��� for thr, fnlio�vine rcawn JSectiori 7031.5. ' � 6asr�tess and Prr,fessiorrs Codc): A�?v ritl' or co�anq�. - , . fvF�ich rcquires a pernifr ro com�rnret, clrer. imp,-nn�, ' ' ...• • � • .. • -. • . ' flelllofisl�,pI.IC��eIY C/f,l'l��'1�Cftlre.nri0r•fC!fs�i':suG'lc�'. . � , afro requrrcr��tlie epplir¢�V fos sucl+ pcmrir'to Jile c . , • � ., .. .. , si;;ued smtcnreiu tF.ct I;c is lrcensed pursuant to the � ' . p�nri.sians oj fhe Contra:tor:c /.irertse I.aw(Chc��ter 9 , - (conunencing ieitli Sertion %0001 of Dicirior� .i of the � � (Ixsrners and £roj��ssions Code) or tlret he is ere���pr � � . � tlierefrom o�ed rlic beris jor ri�e clfeged e.rcrrrption.Any � . , . ' �. . ' . � '. . ciolarinrt of S��ction �031.5 b�mir epplicent fora Pennir � - � sufijects the applicr.nt to a riril J�rnaltr of�ro1�nore Nmri ' fi��e I+�n:ilred dollc��s/SSCOJ.: ' �. . . . . . �. .,.. .... . . ❑ l.as nwncr u([hc p�operfy�cilf do Ihc��urF..:mS ' ' � _ . thc S[[ucture i�no;intcndcd ur of[cred(or salc. ' � �- - � . /Sec, i0-Jl, Guriners end PrnJrrsirms Cudc: Tlte Cnn� � tmc7ur's Lire�uc La���dner uor app1�� tn orr owrter of � � ' properl��wf�o builds ur impro��cs drerean.on;!�rha doer � - . � � such w�ork Gimsclf prorided thet suds imprr ce!ne�rrr . . ._ ... , . . nre no� inle'uded or nffered for sele. If, ho�icrcr, tf�e � . buildin,� nr intproremcm is sold w�itltrrt one yeu� nf , � . . � , - completrar, tlte mrirer-builder will !�m•e die Gurdcu . of Droring thc� pc did not Lxild or rmrrorc for N�c _ . r.. .... . . . . . ..., .. . . .. . yurpore of sa:c./ J, . . - Q�[:as o�sncr of lhi�pniper�y,cm esclusivcly com/ - tracfine nitL•lieenied comrac[ors tp ronstzcct ttic pcoject� . � . � /Secriorr�70�1,Surincrs�nd!'r�jrssinrtc Codr: Tl�e Corr! , ' froCtw's Liccrtr^ La�r docs nnt pppl}� to Rr. uwi�er�i�f '. . . property v:ku f�uilds or inrprnrrs d:crenr�. crtd ilto � - , enirtrocts for sud� projects wi16 n ronbaetDr(s�licEnred � � � � � rnvsumr:to ikc C4n:�arlar's I.i:rnre Leuy. � - 1 mn excmpt undcr Sec. . . .. � I3 F;P.C.for U�is rca�an Date ' Oa:ncr _ � INSPECTOR'S N07E5 ... . .� ••. .'. ` ..�. � .�. . i....� .• . .