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HomeMy WebLinkAbout1810A �vor<�;rFzs•co��r�Ns.�T,ov����,.a,,T�oN �EA 8;g,z-eo, F�,P P L IC tiT l O t� FO R P E R P't�IT � I hereby affirm that I have a'certitica[e of consent to self � , � insure,or a certiticatt nt workers'Compznsation I�s�ra�ce,o� HEA7ING•V ENTILATING-AIR CONDITIONING a rertified cnpy thereof(Sec.3800, ab.C)�' ��,��y n�f7dz��-��D»�N�s����s� � �� I lXl e'erti�ird copy is hereby�turnish�d. COUNTY OF LOS ANGELES BUILDING AND SAFETY !ti � Crrtifiod enpy is filed H�i[li the cuunty building inspectinn � EUILDING dcpartment. FOR APPLICAIVTTO FILI IN noDREss�Q'a (��✓�� b�te Applicant � IPFINT OR TYPE ON�V) L� _ _ LOCALITY/�// �y N`A � CE:RTII'ICATI:OI�LXL'�tNTION FRO�t\VOIiti1�:k5� NO. TYPE OF APPLIANCE Ofi EQUIPM1tENT FEC (y �„( CO�IPHNSATION INSURANC6 � NEARE /) } ('I'his section need not be comp�Med if �he u�orA involveJ ABSORPTION UNIT,BTU � ����' ��F/G,/�I��'��K��� a by ihe permit is Cor one hundred dollars (SI OD) oi less.) . � oisrnicr rvo �^� - v�ocessco av �V 1 cer[ify�tli�t i�Ihe performance<if/he worA for which this AtR HANDLING UNIT,CFM � '� �./ � � permit is iscued,1 shail nnt cmpioy any person in any mannrr - � � I � �' . � � so as to become subject tn Ihe\1'nrkers'Compensation Laws. BOILEft,�TU - F.. APPROVALS �ATE �NSVECTr�'SSlcr�n7U�E U I , W Datc AF����ant COMPRESSOR,8TU ROUGN � d � NOTICF:TO:1PpLICAhT:I(,af[er making this Certificate ot VENTILA710N SVSTEM FINA� �_�1 Z lixemptinn, you should become subject to tha W'nrkers' — Compensation provisions u(Ihr Labor Code,you must fnrth- - � . . .. — wien eam i w�cn sucn permit sn�u ne evacor+anve eoe�e� VALIDATIO J p 3 provisions or this deemed revokeS. FURNACE: FAU__GRAVITY� �� � � ' � � I.ICEM1SEUCOSTRACTOliSDL:CLARATIOM1 F1.00R• BTU � � � � - � I hercby affirm ths�1 am licensed under prnvisiontnf ChaPtrr HEATER: SUSPENDED UNIT I '�. 9 (commencing mith SeeUvn 7000)of Division 3 of the O�si- - WALL , ness and Prnfessions Code,and my licensr is in full forcr and /9 -I ' � - � � � -� � - � - � �� effect. �,7'-!� .� � _ . --!/� .1Do License Nu Lic.Class �!'��— ... : . . . , . . . Contr� � ._. Date.—,���-6� _ . _� . I .. . ... . . am e e �� iium �..IiccnsinS requirements as-1 am a � licensed arehitect or1 n tcgistered profcssionai en�inecr p13n CheCk fee 25°'0 of�6ove. � - � � ' � - - � � acting in my professional cap:icity (Section 7051, Ilus- � � iness and Professions code), PERMIT ISSUING FEF S [,ic.or 2c�:.No. Datc TOTAL FEE /�� • Ff051E 01L'Ng72-�UI1.UE{t D1iCLARATION pLAN CHECK APFLICANT � � � , �1 81.OF, f herehy affirm thst I am exemp[ from-the Cantractor's , . NAR1E '� � ��,Y�bB License La«�for�he following re�son (Section 7031.5, Pusi, �� � �� ness and Professinns'Cnde): ADDFiESS ' :I�'��1� �J.S O ❑ I, as o�ener of thr prnperty,�vill dn the u�ork and ihe structure i+ not intended or i�ffered f�r sale (Sec�iun CITV TEL.NO. ' ,��� �'1 � .r�C` . 7044,fiusiness and Nrafessions Cnde). . .. I - �' � � i,as o���ner uf the OlNNER y�,�.� property, um ecclusivety contrlleting _ __�i��f-ei��-� with IicenseS contrnctors [o conv[ruct thc projac[ h9AI � ' ��� 1 (Section 7044,[luyiness and ProCessions Codc). E1��V;E55 � _ _ ;�,[�/�/ � � I (�.O���"� COYSTILUCTION LLNUf\G AGF:NCY QTV� —' aL.N Q{(y�/ I, . 1 hereby aC(irm th�t Ihere is a consiruetion lendin• �� [�y���{- I�!j D_ _/_ . . h agrncv _'1�.� �s'� far the performance uf the �eork for �chich [his permit is CONTFACT �//�/'�, . . . . . . . . . . issued(Sec.3097,Civ.C.). � � , - —=»/ '� � . � Lender's Name ApDRES 9 n -� �� � Lender's Addresti ��"�� JL� L� � . CITV�� — TEL.�a�'����J� . .. . . .. .. .. . KJ LI 1 cer[ifq that f have read �his application anJ st�te Ihat lhr STATE LIC. � ab<�ve information is correct.1 agree t�com�+ly�vith ull Caun[y � LICENSE ���'� � CLASS �� ... . . , _. . . .- . ordinances and Sta�e I:ll4'S rcKulating Haa[ing.Ventila[ing an4 � Air Cunditwning,und hercbs'uuthonxe representetrves of this. . SF;R Ri?VPRSF.GOR P.XPLANATORy LANGUACI'-.-. . CountY � ❑Icr upon the aboveanentiunrd pruperU' for . . . . . . . . . . . � . . . - . (�LLir(15�'S. /J R ,Signat�C7tee�2f"�—:D����(J(f�/ .. . . . _. . . . _. . .. . . ..�.. , - . .. � � - � � �NSPECTOR'S NOTES ' OtiYNER•EUII.DEF UGCLARAT�ON . ., � � I hcreby afCirm thaE I am�esempt froin'thc Cont�actor's � License taw foc the tolio�cing reason/Secfiwi iO3L5. � _ Business artd�Prnjessiorrs Cade/: Any rity or court�y � . � {^ �' wiriclr requires a penrrit to ronsrnect, alrer, improrr. . �'f '�� � ' " �� �� •�i�'1���`'. demolish,or�epair any srruclure,prior to its issua�ice. �-'-'�". ' . also requtres the cyP��ca�u for svd� perrriir ro jile a , , • ''�' � � � � . signed smtement that hc rs litcrtsed purrumtt �o thc � , � ,�''����, provi.riau of tlie Corttre2tori Lice».ce Lnw�Cliapter 9 . . • - , .. . . , . „,.. ` . (conunencing k•rdr Sectimi 7000/ oj Diririat 3 of tlre . . � ' ��� �Businers m�d Projessions CodeJ or tlrat 1ic is excmpt . -� . \ � , tkesefrom and ti+e Gnsis for the afleged exemptlon.Any ' ' ' - � . violation of Sectiort 7031.5 by eny applicant fora pennrt . �. - � � - � su6jec�t die epplica�v m a ciri!pe��alty of�rot more tfrait . � � �, fire hunAred dollarr(SSOOJ.: � � . ❑ f,as ou�ncr nf Ihe property���itl do thc�vork,and � thc structure is not intcnded nr offered fm sa�c. � �_ .. ... . . . .� ,. ��, � (Sec. 70d3. liusiness anJ Profetsiona Code: The Cwr� ' traclor'a Liceiue I.aw dnes nnt applc to aa o�rner of . � � property wlto builds o�imyroves tliereorr,a�td whn does � � � svch w�orA himself prarided rltar s:re/r imprnnemenrs are not ir.te�ided or offered for scle. /f, hoµrrer, N:c building or improremcrit rs sald witliirr onr year of , � emnpletion, d�e owreervbuilder wi!! I�m�e tLe burden �--.. of provi�rg 11�at hc did no� br+ild or improrc Jor tlre " . � � .. .. . � � `t .. Purposrofsafe.J .. . �.,..' '. . S"'..�-. � ` ._ �,Q I, as otcncr of ihc property.'am�c�clusivcly con- � • � � _ . . , . _, �racting�eitl�Iicrnscd contractors to construct Ihc project � � �.,(Sertion 70a4,'Buriness mtd Projeisio�t.c Code:The Corr� �tractor's License Law doct r+ot'applv��lu an dwner of proyert}� who hurfds or improres thercoii, and wl�o � . � , convac7s fo�sucG pmjecls uiNr a co+�rraclor(sJ ficenred � pursuarrt ro tHe Cou��aetn�'s License Lox�/. . ,. .l; - I am exempt uncler Sec. , B 8;P.G(or ihis rcason '�� Date . - . '1�Z - t _. • Owner 4.. 1 { ',\� " ' - INSPECTOR'S NOTES � ' - . '' . - � � . .-. , � � - . .` - . . � . . . _. .. . , � . , . . ..�. . _ ' .. . ., . .. .. .)