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HomeMy WebLinkAbout1115A (5) , �+�oH�;E:es•co�iri:Nsn-r�oxnLct,�rtnT�oN 's"'�`c /�PPLIC�ATIOf�I FOR PER�IT ���111 I hereby at(irm that 1 ha�'e a'eertificatc of consent to self CE-819 12�801 q' II insute,oracertificateotNorkers'C�mpensstionlnsurance,or �'IEA'1'ING-VENTILATING-AIR C�NDITIONING Lj „�a ccrtified cnpy[hereof(Sec.3800,Lab.C.) . Yol�c�No. Compun� RepubllC Indem. ' COUNTY OF LOS ANGELES BUILDING AND SAFETY � � Cer[ifird c�p}'is hereFy furnished. � � � • � Certifled enpq is filed with�he couniy building inspec[ion - FOR APPLICANT TO FILL W cu��olNG �e,,�,,�me„�.,, • aoonE�s 23601 E__Falcon View Uate�L_25L��npp�icant AL1S0 Ali (PRINT OFl TVPC ONLVI LOCAUTY CiSR7IPICATC 0['EXI;NPTIO''7!'k0�11VOR6Ek5' NO. TYPE OF ACPLtANCE OR EQUIPMENT FEE Diamond_BAr, CA CO]1PLNSATION 19SURANCL NEAREST } (ThiS SeClion need no[ 6e eomplCtCd if tLe wprk Im'Olved AEiSOFlP710N UNIT,6TU CROSS ST. a O by t6e permit is for one hundred dollars (5100)ar IcssJ DISTFliCT ND. ORpCE55ED B� U [certify that 'n the pe�(ormance o(lhe x�urk for«-I�ich this AIR HAN�LING UNIT,CFht . ,1M, , permit is issued.I sha�l nnt empioy uny persun in any manner �� O � ' •���n�' O so as tn hecome subject to thc 1VorAers'Compensation laws. bO1LEfi,CiTU _. — n{+pqOVALS DATE �riSVE^T n S�.GNATvaE W Vate AFi'�iCant �. COMPRESSOR,BTU��V OOQ �-� �� — - �__._ — ROUGH r2— tail NUTIC3i TO AYNLICANT:1L af[er making this CCrti(icJlC of VENTILATION SYSTEM � � ? l:xemption, yuu sYiould hecome subject to the \Vorkers' FINAL . Compensation prm�iiions of the Lahnr Code,you must Corth- EVAPORATIVE COOLER . � VALIDP�TION with comD�S' with 5uch provisions ur this permit shatl be , deemed revohed.� FUFlNACE: FAU X—C,�n�y, �s Y— I , . UCENSFCDCONTRAC70IiSDECLARAT]ON �. FLODFt BTU_L{[{�1,1�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. 6 inlet outlet 1.75�� 1�D � ��nc �+ n --�—-—. �f.icensc Numbcr�Slll�S_ Lk.Class_3r�.1L� � ' `' 8L25L87 L'ontractor�ll$Q�1T_ Datc_ . ' � Q��1 am exempt from [he licensing reyuircments as 1 am u z� 1 1•5 1 � Lcensed architect or n registereA protrssional engineer Plan ChCCk fCe 2540 of above. . �`�� � � �� atting in my professional capadry �s�n;�n vos�, ous- pEFtPJI1T ISSUING FEE S � 1 • `4�•�� � inees and Professions Code). � 1�, �_ �. � Lic.or Kcg.No. Datr TOTAL FEE Q],.pp , � 6 °4�'Q�� HO}tE OL4'NCIL�[3UILOrR DI;CLARATION pL�1N CHECK AFPLICANT � , . O S.P 7�H 7 � 1�hereby aCfirm that I am e<empt (rom�Lhe Con�fac�or�s NAh7E A11S0 Air — Air Cond_.& Heating . l.itense Law fur Ihe followinK reason (Secti��n 7031.5.Rusi� , ness and Profrssions Code): ADDRESS2�3�Z�IadfS.Q�Rd._,_IIni�C � � I,as o�vner of Ihe Droparty,wiil So the work and the TEL.NO � � struc[ure is not intended o� offered for sale (Sectiun CITY 11SSlOR Viejo_,_CA�951-1266— . ' 70�a,IIusiness ond Frotessions Codt). . ' , ❑ OWNEfi 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 9044,Bosiness and Professions Cude). . � CONSTRUCTIOV LENUING AG1iNCY C�TY Yorba Linda� ,ri/� TEL.NO. �, 1 htreby utfirm th�t [herc is a construction lending aS�'��3' CONTRACTOFl � � ' � for the performante of the a�orA (or w�Lich this prrmit is 1�1.150 Air — Air Cond. se }iC'H . . � , � issued(Sec.3097,C«'.C.). . . Lender's Namr ADORESS 23342 Madero Rd:, Unit G � � Lender's Addresx C�Y� [�1SS10R V12�O� CATE`."o.g51_1266 � � I cir[ify thui I ha�e re�d this a���iicutiun anJ state that 16e STATE LIC. ��7 � ,, � abave infnrm�tion i;eorrect,1 aKrce to complp��cith all Cuunty UCFNSE NO. �10672.6 c��+�; 1c.� � ordinanccs ilil(I S[JIC laH�s rcgulatin�:}9e�tin6.�'entita[ing und � Air Conditioning,and I�ereby�auth�rire represen�atives af this SI:E RI:VFiRSE I"OK L:XPLANATORI'I.ANGl1ACf! �� , � � County to rnie� upan thc �bu}•e-mentiuned pwpert1' Cec . � • iucp :t'.�purpose- ' /� [� . _. . .. 1,5,� C�"�5-�'1_ Signature o(fkrmi[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....� .• . .