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0839A
`���'���k�•�°"�'���s,����>"���'���^��^T��^ 's�"'� APPLICATIO�f�''�OR PERPVIIT 1 hereby aCfirm th:rt I L+ac. a eertifi�ate uf cunsent to self CE-91£i @-801 � ins�rt,��r a certifi.�te at�vork��n'�oinpenution]nsurance,or HEATING-VENTILATING•AIR CONDITIONING a certified conp thercnf(Src.3F.0Q l.;ib.C.) Pulicy Ku. Comp:m� '�, I ❑ Ccrt�f��d a��y�z h�•r�,�•y ti�rni�ti.d. COUNTY OF LOS AfAGELES BUILDING AND SAFETY � Ccrtificd copq is filaJ xitii iLc cuunty bulldinq insp.-ctinn 6UILOING departrri.:nt. FOR APPLICAPJT TO FI LL IN -13�`� p� `��..� ADDRESS U�le q���lii��nt (PFIINT OR TVPE ONLYI . LOCALITY � ��_ — CI�:RTII�ICAi�1:01-I:�l:7.f1'7I:)��I'ItO.'•11'+OItF:(.125' NO. TYPE OF APPLIA.NCE OR EQUIPMENT FEE �O^V�l��V CO�!PI:NS:\TIOV IKSUY.ANCI�; NEAREST �� �^_ �, CROSS ST.� L:.�Kt�if,t d . (�Ihis Section need no[ h^ cnmple�ed if Ih; t5'urk invoh�td AESOFPTION UNIT.9TU � � by tiie permit is for onc ]mndred dollars (SIOD) or lesc.) � DISTRiCTNO. PROCESSEOBV V I ee�[iTy'[ti��t in [he ��.rfe�rm:in�.�uf tt�e�•.<�r1;fur�vliich thil iAIR HANDLING UNIT,CFM '�i / ¢ � perrnit is issucd.I sh�li nnt ernpluy:u�> prr�„�' m�manner �J�,� . .-iI � �d /Q ��u,��C� O � `se��,ss to h.���„me subjce. n tl��a P�urkers'l. �•�ren�iu� Lux�s. ¢OILER,67U—•C F'T-" � I � l���� APPROV.QIS DATE INSPECTOR'SSIGVATURE U � I)atc__ pE�li�_.in _ � ~CO!v1PRE5SOR,6TU a ROUGH J y NOT{C[;TO r�E'i'LIC'ANT:1(,a!t.r mi}�,�nt thi�('crtif'i�;�tr��f VENTILATION SYSTEM FINAL / � �`— ' lximptinn, r�nu .houl�l bi�i�nm�� suhjzct t�r th� 1';i�rki•rn' � J Compcn�sution prnci;ionz uf thr Lul•nr Cndt,you must fnrth� , �.;ti: com t «;u, t�cn �e�mi� si�ou n� Evaaoaanve coo�EFl VALIDATION P) Prucisions ur �his • elcemed re���il:ed. ' FURNACE: FAU_GRAVITV__ LIC1:\'SF.0 CO":TI:AC'TOI'.`h::CLAI:ATIOV FLOOR� 6TU ��, [herchy a((irm that I:un Ii:rna.d�nder pru��isinns ntChap[cr HEAT[R: SUSPENOE� UNIT �'. 9 (commencin��rith Srctinn 700f1)i�f llivi�iun 3 nf thc(3usi- LVALL ��. ness and Profrssians Co-.Ic,anA m1�liccnse i,in full(arce and � eftrct. '�, Licrnx,Numher l.ie Cli,s � . Contruetnr Ilute . . . . � 1 am ucmpt lrom thc liccnsing reyuircmcnls as i a IicenseJ architrct � ragis:ered profarsionat enginecr PI2n ChCCk fee 25 o o(aboVe. � � � actine in m)' Profcszi�,in�l capucitp (5�'ctian 70[l. �os- �� ' . incss��d r�ut.�»io�s CodaJ PERh11T ISSUING FEE S ! �.ic.��r�:c�;.n�,. l��to TOTAL FEE .�.J.J�(� Z � E10\fI:01`:!�F:R-13lI�LUI�.I:I1[:C'1..�1:ATfON p.1N CHECK APPLICANT '�, �OB�.A:9 R ���NT��✓� ��t� • • •.��• I hereby affirm thal 1 am e empt frnr.r thc Contnctor's NAM ��, #; 8 � I.icensc l.a���fnr thc fniln���?ng�r�.isun (Scction 7031.5. Busi- � � �� ' . . �,<:��a rrore,.so�:,coa�). nooFles�3-�W.` <pvyV_a...���c' Y;��•33.50 ❑ i.:,l ���,�,��< <,r u,�• ��<<��.���.«ri a�, m��.��x :,�,a �n�� ... . struct��rc i: not intcnded or o(f:�reA fur sal2 (Scctiun CI7Y � � TEL.NO.��.:�_�\�,�� .. . . . .3 J�l S O� . 7044.Ilusineti>an:l Prnfe�sium Cnda). . , f .�.3 � I,as n«�ner uf tl�e OWNER��Q -_�_ `_ , , �`$� properry�.am exclusicely�contracting n�'O" �itl� liccnsc� c��ntr:i�tors [n c<instruct tl�i- �roii�t h1AIL .l'� _ 1_ ,� (Sectie�n 703a,Elusiness snd pro.'cs.�iuns Codc). AOORESS ��-a'� �`-'�� ._ � � (:OtiCTItI�C'fl()\'Ll_til)I!�'C:A(;l:h'(;1' CITY TEL.NO. ., . f heroby affirm thst [he:e i. � n rstructiun Itndi��g agence C'} ` ` ' , fur Ihe p��rforma�ice of iLe ���urk tur �rhich [his permil is . CONTRnCTOR �)�>...�-� �� . is}ucd(Sec.J097,Citi�.C.). v ��� � Lendcr's hamc ADORES:; ' I � i Lrnder's Addres� CITY TE�.NO. � " � 1 ccrtif5 that I havc re.�d this appti;;ition und siutc tlmt the �. STATE LIC. � above Infoirti�ti�ln i.c Cort�•c[.1 a�tree 1��c�in��l)���'ith 911 C�uun[y LIC:ENSE NO. CLASS � � urdin�n�es and Statr tu«�s rrCulating Ilea[ing.Ventilating und . . Air Cnnditinnin,,and hcreLy�authurice rcpresunalivrs of this Sl?G R4:�'IiRSf?POR F:XPL.4NATORY LANCUAGI; Cuun[. �u � . npnn thr ;�bove-rirntionrd pruperU' !nr ��� n tioi�. �,nsr� ' �.,— ���,,�1_ ; s;�����r.,<,<<��.�,,,,,�,� ��,« : i I . . . - -� _- . _ . •( . . . . .__!__-._...-----------._-- ---'--._-' � . � - 4 I'. �,.�.'7 il'.. ...,-_�- _-____—____—._.____-___________.__._ o���,:r��-i;cu.o:.t:L�r.cL:�r,�;T[or. —' ___'_-___--__--________..___ I t.�n�.��,a'li:m ih.tt I am eccmpt Crom tlic Con[raCloi s , � ___.__.____._..._..____._-__. _________-.�____ 11cr;: �. !.o,�, tur ih., f:J;n�ing rc�son(Sretio!i 703I.5. � � , � . . . . i':ubt�•.� un:! 17<,ft,tiu�is :ud:J: :litr riq� ur co+�nrt' � % �'., '. . __-___—_'.__. .�•':i,.j� r':'.,i:i•:•' a ( � .__.. j.�� - � -'._�__._'-_'_______' p�•r.:r ro crarnn�cl. a((cr. un1lo�C, . �.. , . . , . ... � ' - . � J �..,,:.o rt,:��r un' �rruRurc.prior In i(f isr�:ann•, � . . , -..�_�._�_�_,_., -_..-. ..1,�� rr,.•:irc; Nc cpp!icrr,f Jrr n:d: prrrr�i! !o fi!r c � '� `.. ` . _. _ . ' . : � _ _- . .. .. . . . . . . . � ri.:;,_,! .v:r^rr:r.f ri:a! Hr is lic�ns^d pursuc.�if t i nc� --�--- �.i._ .:c of iL,� Cinur�i�7uri Licc�tsC La�v(('hp;'ter 9 .. _ -_ . .. , ..� .-: - �.,. xid: �rn; 700G1 r,f D:uioit i of 1@t . , .., ....- .._ ,�... , :�� r � � . . __' ___-..__.___.._�__ __ 17::�Jcc., ::�i�,' :rr.(:s:;ior.s ('od�°J Ur Iha7 l�, rr ccem;>t ' �L.�rr;i���c�c;:r't!u�l,rrf;fnr tkc cllr,:zd e.rem�vtioi�.Ariy � ". �.. . --' --`----_-'------.-_.. _-_-_-___ __-._----- .r:..i.;�.o�S._.r,cr ?n;l.s 1��mn v��f.ricu•it f�raPr�vnir ' " -. - . . � - . ' " . � , s�:L;�;���tr.,rrli;i:c�rt fn a ririi perialp'of rtut morc thcn � � �� '� � /ia�,: ` ,. : . —- -�-- --._.�.-------..-_-._------------- i,i;rG�.� :�,.:;��.!: . � ., -, . _ . ..- a � �;II r -�� o l ,.�71 �c } ��:��.; ` . �J1 . �� .� tl e� -_� � . 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