Loading...
HomeMy WebLinkAbout1807A (10) ~coaxras•couri:Nsnr�oNur.cLnRnnov '6"'Eac �rPPLIC/siTIO�E FOR PER�IT 1 herehy affirm ihat I hace �'certificate af consent to szlf C[-S16(Z-f101 � inxure,or a certificala of lVorkers'C��mpensation Insurance,oc � acer�iti��nc�oythe*^nf(Se�.3S00.L �'.) HElyTItYG•VENTfLATING-AIR CONDITIONING ,��'(�.�����9..��80,�.�_��.��C I (I/\<1er[ified cnpy is h�reny rurnishrd. • COUNTY OF LOS ANGELES BUILDING AND SAFETY 7 1 Lj Cer�ified cupp is filed with the couMy buiiding inspectinn BUILOING I���� - depurtment. FOR APPLICANT TO FILL IN Dute Applicant IPRIN7 OR TYPE ONLY) P.ODRLSS LOCALITY�'J/ Cl:RTI1�ICATE:Or EX1:�IPTION i�RO:+11\'OIiKC�:RS' NO. TYPE OF APPLIANCE OFl E�UIPMENT FEE �r�j _ _ CO�IPLNSATIOti INSURAtiCC , NEARES � T (Thts 5�ctian necd �ot be COR1P�etC� 1P fl�e u'prA involved ABSORPT�ON UNIT,6TU � � � CROSS q b)' (IIC (ICiRII[ IS fOT OtiC I1U11(SfC(S cIOIId[5 (S�OOJ Ui ICSS.� ' DIST.��T.�. PROCESSEDBY b I certify th�[ in the per(nrmance nf the«�ork for���hicl�this .4�R HANOLINC UNIT,CFM I � �� O permit ie issued,f shall not amploy any person in sny manner � so as to hecume subject to the R'orAers'CnmPens�tion Laws, ElOILEF,ESTU I �... �- APPROVALS DATE INSOEC'�R'SSIGNATUFlE (� Date Applicant � COMPFl[SSOR,�TU_ W FOUGH d y NO'iICE TO.APYLICAKT:If,a(ter m�king this Certificate of VENTILATION SYSTEPA FINAL � `Z.,. Z tixemption, you shonld become subject tn the 14'orkers' � Compensa[ion provizionc o(the Labnr Code,you must forth� . � w«n �ompiY ���m s��n �ro��s�o�z or u,ts �+�rm�� snau nz EvaeonarwEcoo�er' VALIDATI N deemed re.nked. � FURNACE: FAU—_.G(lAVITY__ . � � I,ICLRSIiDCONTRACTORSDECLA{E.4T10� F�OOR� �TU � - I herel�y aCfirm that I nm�icensed under(�r<�visions�if Cha�+ter HEATER: "U�PEN�E� UNIT 9 (commencing�vith Section 7000)of Uivision 3 of the Husi� LVAL� � � � �rst and Professions CoJe.+and my licrnse is in tull force and � � - - � �� . . rrr���,. // �f� _�/—��s� Q� License T�um����KJ I.ic.Clavsp'n-+� �.� � . . - . . . . .. Contr� . . :_V�—✓�� _. . . ' _—. ' _ . . .. _ . _ . . .. � � I/�..i,. �m thc licensin6�eyuircments as 1 am a licenud archilect or o registered proftssional enginecr PI3n CheCk fCe 25°0 of a�ovC. " - - - ac[ing in my prnfcssional capaci�y (Sectiun 7051, 6us- � iness and�'rofessions Code). PERI111T ISSUIPJG FEF$ $y�j'�� r I.ic,or ReF,t�o. uate TOTAL FEE !�.�� �� �S O 7 A � f10�fE OR'NI:EL-DUfLDP.R DLCI,ARATIOM1 PLAN CHECK APpLICANT � �,e •,� i •8 I hereby affirm that 1 am exempt from'thc Cuntractor's NAME .� . _ . �I'��e{IY 3.50 License I,u�e for[he (oilowing reasun (Section 70J1.5,I3usi. , . , . � nrss nnd Professions Cnda): AD�FtE55 e j'•� �3,F p� � 1, as owner of the properh•,�ciil do the �vork •nd the CITY TEL.NO. ��Q� �-8� structure is nnt imended nr oftcred for sale (Sec[ion . 7044,Flusinesx�nd Protessions Code). . � 1,us owncr of the ' OWNER � J/���,y�� — pruper[y,am ezcWxivcly contracting fy(/'��J �ith licensed contractors to cnnstruct t)e project MAIL �/j'1„ _�`��� (Sectian 7044,�usiness and Professions Cnd�. ADDRESP (�7/!! �f CONSTRUCTfO�LLNUING AGCNCY CITv�� � 7 �.nro.�b��/b/J� 1 hereAy atfirm [hat [here is a cunstruction lending agency � ` �- ��� � for the perfnnn�ncc qf thc work (or �rhich this permit is CONTRACT � - � . . . .. issued(Sec.3097.Civ.CJ. - � - /1 � . � Lender's t��me AODR[55. � +�/ri,_� . . . ' - _ .. O�—. �!GrJGT✓ �- � Lender's Address CITY � T[L.N�,C��/�, [ecrtify th�t I hsve read this uDP��ca[ion and stute thst the ��_ �J LJ . . ... . _ . _ . abuve inform�ti<in is correet.I aF*ee to comply�vith all C�>unty LICFNSF .� �Qa�C A55 �� . . _ , _,. ,_ _ _, . ortlinance�and State la�vs regul�ting F[e�ting,'�'entilating and �� Air Conditioning,and hereby uuthmize reprcsent�tives nf this S1:I;Kl�;Vl:HSG I'OR tiXP1,ANATORY IANGUAGC � Coimt>' to en[er u0�n the a6ove-mentioned pruper�)' fnr . .� . . . .. . . . .. . . � o��i�"���ii�-��-.�� �J _ . . . . ure of Permi[tee Uate ��� . � .. . . . . �. � , � � . ' INSPECTOR'S NOTES . . ON'NLR•IiU[L➢EP,DtiCLARATION ' �� I hc�eby affirm that T am�cxempt from tl�i•Contrxcinr's - . License Law for tlie follou�ing rcau�n(Seetiorc 7031.5.' . � � . , 6usineu anA f'rofersiais Code/: Any rity or county . . � , i, whrclr requirer a permrt ro conrm�cr, after, imprarc, -�- . . . .. . , demolish.or repair a�{v stnrcture,priar to!ts issumtce, ' -. ' ' � a&o requires the opp(icmif jor such pemrir to file a . � �� . „ � - . � signed rra�emenr tl�ar Re is liccnred pursuenr ro rhe r� , . ' � prarisions oj�he Corura@ror's License Law IChapre�9 ,J- _ . � � , , �� (cammertcing with Section 7000J of Dirisio�r 3 of die . •, . � - � � � � ' � UusLtess ar:d Profecsiana CadeJ or rkat l�e is e.rrmpr lherejro�n and thc bcris for dre afleged exemptiar.Any -. ••.t c'�. � � vrolalion of Sectio�r 7031.5 6}'mq•cpplita�it for a perrrtrt � - , � . subjectr dte app(icunt to a ciri!penalt3'oJno�rnorc than �. ' fh�e h�uidred doflnrs/$500/.: - . � [� 1,as ox'ner of thc proycr(S'�eili do thc�cork,and the structurc is not intended or of(cred for sale. ._ ,, / �� � � ,- , -��= � (Sec. 70�1-1, Busiirest mrJ 1'rojessioris Code: Tlic Com -- -� � -�-'�� ' � rracta's Lrre�ite La�c Joer uot applt� to m+ ouvrcr oj . � propert}� w6o bttilds or iniproves 7Lercon,ond who doet sud+ wvrR Gimselj prm�ided d�a� surh, impro��emettts are not intended or oJjered Jor salr. !J, hox�rrer, rlre � burldinF or i!Ilproreincqf is sofd k�ithin onc }•ea� oj , mmpfetron, Ure owrter�biri(dcr k•i1( lia��c dae 6urdeir - � ' of proving that he did r!or build or tntp�onc far dic .� `. -- •.� - . , .. _ . , .:Pi;.paseolsnle.) :. ' , �v•. �. � _ -- ' _'� f,��s b�rncr nf ihc,properl�^,am c3d�sivciy con- . . . . „ � �• __ `�Iract�ng n�itli licrnsed contractors�u wpstruct the project .,,, � � � � `/Seeiiar-:OJJ,Busi�tess ai�d Professiona�Code:.7he Con- . � bartori Lrrerrse La�c doct nor appf��.iu ah.'o�vuer af � property x�iro 6uildr or impro��es the�eori,�ar+d �cLo controets for sude projects�rirh a rnrtrrac�or(s/liecnscd t•�"' . puerur�rt!o rlre Cantracrur i Lirense Law/. � F; . - 1 am exempt imdcr Sec. � B&I'.C.(or this reason I �..,� -� Date , t.;' . Owner r' , '.�,` . -_� •• - ' �.y `r INSPECTOR'SNDTES � • � �� � � -� �� . � � - � .�. _ �i'_ .. .. . " .,, . , ._ . .` ., . . � . . i '