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HomeMy WebLinkAbout1813A �+o�ih�ais•coa�t�r:Ns.�no`orcLnk.ar�oN �EA868,Z.so, �PP 'LIC�,TION FOR PERM IT 1 herehy affirm that [ have a rertititate of tonsent to 5eif . . /7 insure,or a cer[ificate of tt'urkers'Cumpensation Insu�ance,or - � - ' `7 1 ucertifie�c�/��/j`y�theroof(�S+,e�c.3S00.Lab. ) HEATI��G-VENTILATING-AIR CONDITIONING U oli Y�/Y���l.�e�an!.`:�'{���� . ; . . . � COUNTY OF LOS A�JGELES ' � Ccrtified eopy is herehy furnishrd. BUILDING AND SAFETY � Certified cop5'u Ciled with the eounty AuildinR�nspection dzpartmtnt. FOR APPLICANT TO FILL IA Qul�o�r:c ADDRESS n �f�i� Datc Applicun[ � . (PRINTORTYPEONLVI� �C.���_L«/�'GL �N" LOCALITY C2:RTIf'ICAT[Of EXIi�1PTION C20n1 l4'ORKI:RS'� NO. TVPE OF APPLIANCE OR EQUIPhaENT FEE � ' COSfPENSATION INSUKANCE NEARF ' } (T�iIS SCCfion nee� not bC CORf�1�Cted if[he tVO�k invo]ve(� A6SORPTION UNIT,67U CfiOG' " by thc pctmit is for ane hundred doilars (5100) w Icss.) - ois�ni INO. pROCE55EDBV d [cCrtify Ih�t in the p�•rf��rm;�nee of�he���nrk Cot�4hie1�[his AIFl fiANDLING UNIT,CFM , permil is issued,I sh�ll not empiny any persnn in any manner I �� ��� O so Os t�become subjec[to Ihe 1Vorkers'Com�encatlon La���s. eOILER,87U- F APPROVALS DATE INSPECTO'SSIGNATUPE' (,) I W Datc Applicant COMPRESSOR,OTU ROUGH � NOTICL TO AVPLICANT:If,afttr making[Lis Certificatc ot VENTILATION SYSTEM1t I FINAL �' ? ]ixemp[ion, you should �ec��mc suhject tn the bYorAcrs' Compensatiun prnvisions ot the Labor Code,you must fnrth� '� . � w��n mm i� Hi�h sucn permi[ si��u ne evovo�nr�ve coo�er� VALIDATIO p) Provisions or Ihis deemed reveikcd. . � � � FURNACE: FAU-GRAVITY�� ' I,ICF:NSEUCO!vTRACTORSDI:C[.ARATION FLOOR: eTV , � � � � t htreby affirm that I am Iicensed under provisions of Ch�pter HEATER: SUSPENDE� UP,IIT 9 (commencing with Section^000)o(pivision 3 oC the Rusi� WALL nrss and Professionx Code.and my license is in fuli forn•and �i������_ �rO� � - - � -� � � effrct. `� � Licrnse Numh���r� ,ic.Clsss���,3_ . . . - . - .. Contr;� ' __ __ _ •ate_:6=��4--/- _. - __ _ . .... . . . . . . . . � I an .>m the licen<ing requirements as f am a � licrnscd�architect nr a rugistercd profcssionul engincer p�an check fee 2590 of above. � �� � ' actinc in my professional capacily (Scction 7051, 6us- � � iness and Professions Codc). PERMIT ISSUING EEE S , . . .. . _. Lic.or Re�.No. U�tr TOTAL FEE ��� FIOS1Ii0��'NER-IIUlLDf_}2D[iCi.ARATIOti pLANCHECKAPPUCt.NT � �I �• 1�''�k,�? 1.hercAy affirm [hat 1 am exempt from'the Contractor's NAME . . . . . . � . '�(°����5 Q License law fnr Me following rrasun (Section 703L5, f3usi- t �,�2��5 = ness and Pro(essions Cn�1�): A�DRESS ' . , n� � �, as m.��c� or u,e p�operer.��;u ao tnc�vo.x ana u,e � � 1 L'D�1=8 1 . structurc is no( infentled or offered far s�ie (Sectinn CITY TEL.NO. 7044,Businesc und Protcssions Codc). - � . ❑ OVJNER ],as owner oF[he propzrty,am ezdusively contrsctinG �ith licensed contractors to construct Ihe projec[ MAIL � � (Section 704�7,DuslnessanJ Yrofessions Codu). AO�RESS �J_� .� �� COKSTftUCT10N LL:NDING AGF;NCY CITV -��y`/'J-c_-_r J T _.NO.IL,`-�jrU /�� I hereby affirm ihat there is' u construction ltnding agency 6 V / -� f�r [he perForm�ncr t the ���ork for ��'hicli this petmit is CONTRACTO� ����) - _ . .. issued(Sec.3097,Civ.C.). (//(J . � Lender's Name AODRE = /7y � /�� . � - � - � � � Lender s Addresx �/'��C��"! - �- � �` /Qn� � CITY � �'7';, /J�_�� TEL.Nj]j"t-��"f'C/ . . .. ._ . . (diyl.[.R)�(i!/ILCSL �7V I ceriify tliat 1 I��ve read [his ap{+Ii<ation and 5t:+ie tliat tlie STATE � /+ LI(:. " I above inform�[inn ie correc[.I a�;ree to eomply�ti�itl�aIl County LICENSE ���v��y CLAS^ ��-u � _ . _ . � nrdinances and S[are la�ss rc6������ng Hratin�,Vrn[iW[ing und / "�`�"' Air Canditioning,nnd hcreb)'authuriec representatives nf t0is SI:Ii RCVF:ILSF.FOIi�F:TNC.ANATORY LAKGUAGP Cuunty ta cnter upon thc '. �- entiunrd/pro�pert)' fur � . . . . . �t�� u�p�,ti��_!��-�_2.1 l�LO�O� ��.� Signaiure of Permitlne U�[e ' � � INSPECTOR'S NOTES OWNER-BUILDLR DECLARATIO� � . � . � � . I hcreb)'�'atfirm[liat I am e�ecipt�from 1hc�Contiactor's' License Law tor the (ollon�ing rcason(Sectinn 7031.5; . . Busir.ers ond l3�ofessions Code/: .l�ry ci�y o� counly � . . . wliich requirer a pem;ir to cons�nect, Qlrer, irnp�o�•e. -� � . -� --.5 � ,, dem.ofisG,or repair any strucrure,prior ro its issuance, � '•}�, also requrres rlie ePPlicmn for such pennir ro jile a . - � � ' � . rigned srarcnrenr rhar he i.i licensed pursumtt ro rhe � . � yro��isians pf the Cor�na�ror'r Lttense Lax�/CGapter 9 . � . � ., � ._ , , , fcommei+cing k�itl� Seetion 7000J of Divitiai 3 of tHe � � � � � � �' � Busiiress and 1'rofessiais CodeJ or tlict !�r is exenrpt � � 1Gerefronr a�id rhe basir jor the alJegcd e.cemprrme:tny ' . _ � ,_: violutrart of Sectio�t 7031.5 b��m�y eyplican�for a pennit - � - , subjecis d�e applirmtt to a civil pet�cf[p ojtto�nmre then � fire Gundrrd doAars(5500J.: . ❑ 1,as m��ncr of thc pwpert3'���ill do thc u�nrk,and . � - thc structucc is not intcnded or offered for salc. ' _ _ ,.,. � � , , � , . ' ' (Sec. 703d. Businesr and Prafessiorre Code.' Thc Curr- - -- � ' , � trector's I.icense I.ax�does not applt• to m+ oicuer of � - proper7p who buifds or irnp�m�rr rherron,artd x•ho does sucii work liirnsclf prorrded tJ:at suclr iinp�o��crnc�ifs . are not infended or offered for sale. If, ltowecrr, tlic � bui7ding or rmprorement is sofd widiin one year of tompletion, t�re awr�ervbttilder will 6mr tl�e bwAerr . i,`., � � - of prc��ing that He did rrat hurld or 4nprore Jor tlre . _ _ ; .. QurposeoJsalr.J .. . .. ,. � � - " ' �. Q�.I, as ou�mm�P Ih�property;�am csclusivcly com . . -� -- _.. .,, . � � tractin�•�ei�h licensed eontractors tu construct�he project � � � . (Section�70J1..Businers nnd 1'rojescioris Code;�,Tlir Con• vactor's Licensc LOM(IOfS nm aPP<<' tti'aa pwricr oj properfy w�ho Guilds or Lnpro�•es dierron, attd wlvo contracts for sudi projects�vitk a coritrecro�/s�firer�sed " � pevsumit ro thc Contrarrnr's Litense La�.�/. � .. _.. .�'1 I am exempt under Scc. � B&P.C.for this reasan • Date , , .'i`..\ .'``. j• � -- O�sncr � . _ • ` . � _ , �� INSPECTOR'S NOTES - - - � .. � : . . . � .. . _ : . � .• ��ti�, .. ^.` - _