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Home My WebLink About0527A (4) ,��'OItKf;RS'COS71'ENS.4TIONDI!CL:\It:1TION 76A364C APPLIC/aTIOf�J FOR PEPMIT I herehy 9fficm that I hare �ttrtificnte nf consent tn self ce-818(2801 ♦ �� insure,oracertificateol�t'urkers'Com ensatinnlnsurance,n� HEATING-VENTILATING-AIR CONDITIONING a crrtified cnp tli if(E�(��0�^�I ) o�Y��wg��-1I C�mpaii3" � ��m�vJ �LD� � I Certified copy ic hc�ehy fumished. COUNTY OF LOS ANGElES BUI LDING AND SAFETY , ;.ertifieJ copy is Icd wi�h the county building inspectinn FOR APPLICANT TO FILL IN aui�oiNc�-��3�7b ?�� 1 e{'!�rJ—_Ci j, 6 IPRINT OR TYPE ONLY1 A�DRESS _ uate_ �3 AFpliwnt ^ LOCl�LITY/ ClRTI1'ICATli OP F.XE�IPTION PRO�t 6'ORKC.RS' NO. TYPE OF APPLIANCE OR[QUIPMENT FEE V vL�� CYG`_.T_� CO".iPFNSATION INSURAhCi.: . N[AREST��6 fy.f�'t' $'S//YF' } CROSS ST. /�/ j� a (Thic section need not he completed if the �eork invokrA A950RPTION UNIT,E3TU �W,,�/1J � by the permit ic for nne Lundred dollars (5100) or Iess.) ois�nicrrvo. vnoce<_seoov V 1 eertify that in the per(mmance n(the�eork(nr�chjch this AIR HANOLING UNIT,Cf-M �O � � permit is issued,I shall nnl empiuy;�ny person in�iny manner � � sn as to becnme subject to the\Vorkers'Compensation Laws. 601LEFi,f3TU U //1/] � Af'PROVl�LS DAT ' on'S� .rv4ruRE W Uatc :1p�licant �. COMPRESSOR,6TU��KV� a_ ad (�OUGN 1,��- y NOTIC};TO APPI.ICr\'.JT:If,after making this c<«;r��e�r VENTILATION SYSTEM I T Z Iiremption, yqu should hecome suhject toi tlie 1Ynrkrrt' FINAL — Compensatiun pracisiuns uf the Labor Code,you must fqrth• I VALIDr�j1=J u�ilh cnmply with such provicinnc nr Ihis permit shall be eVAPORf�TiVE CvOL�R � deemeil re��nked. � FURNACE: FAU��?,y1f7Y—�,..,(�oO� Yt LICFYSfCDCONTRACTORSDF�:CLAIiATION FLOORr �TV_ (fUU �� !I herehy aftirm ihat 1 am Iicenced under provisions of Chapter HEATER: SUSPENO[D UNIT �_! 9 (mmmencinR«'ith Srcli<in 7000)of Divisinn 3 of the f�usi- WALL � ness and I'rofessinns Code.and my license is in fuil taL�e and effect. q � (\) Licensc 4umhc�/�`pZ�eJ� Lic.Cl�ss�C/"-' � Can[rsc��.V�)�+_/�;1a�/��I � � 1 am exempt from the IicensinR�equiremente as 1 nm o iicenscd srehitect or a re�iscereJ profession�l enginrer PI3n thCCk fB0 25�6 Of 360ve. � actinF�n my profes5ional capaci[y (Sectinn 7051. Dus- — �necsand ProfzsvonsCnde). PERh11T ISSUING FEE S� l.ic,or Iteg.N�. D�[e TOTAL FEE � 110111:U��'�1LR-DUILUI:12 DI:CL:1R.qT10^1 p�pN CHECK APALICANT 1 hereby affirm [hat 1 am esempt frnm�the ContraetoPs NAR1E I.icense I,aw fur ihe folioxing rcason (Section 7031.5,Dusi- . ness and Prnfes+inns Cnde): ADDfiESS ❑ I, as u�vnrr uf 16e prup�rtY.��ili do Il�e�+�o�k�nd li�e structure is nut intenJed �x uffereJ for sa�e (Sudion CITV TEL.NO. 7034,flusiness and Prnfrssinns Cndt). � ❑ OWNER r7 f,as o�+��ner ot ihe property,am exclusively contracting 9_fT�Gr��r�tG _�R�'? �Q'S 27 A «�ilh licensed con�ractms to construct the project MAIL (r{'�r` �O L/ ' (Section 7034,I3usinecsand Profec�ionsCode). ADDRES:�_� �J /J�� '�.��$ CITY TEL.NO. CONSTRUC710N LiNU1NG AGENCY L� � '4 8 fl 5 0 [ hereby affirm that �here is a runctructian lending agency for the perfnrma nf iht �r�' fnr u�hicl� this pen it is CONTRACTOR /DGl�G�T •"4 8&5 0� issueJ(Set.3D" C�v.�'.L (!'L V . Lender'sName _�I�^s-�_D S`f'� ADDRES��O� ��j ._�(u� -11,09,=81 Lender'sAddreSs�U_� � —�� CITV ,tl�� TEL.NO. I cenif ihat I h��e rrad[his lic tiun and s[ate tliat Ihe ��--�� Y -FP STATE �J q LIC. aba��e infonn�linn is correct. �gree 1 i coinplr�sith all Couniy LICENSF NOJ �YJ CLASS�� eirdinances and State la�cs eR��tir.He;��ing,Veniila�ing and Air ConditioninG,and . by aut�,iriie representatires of�his SF.E RF.VF.RSL FOR 6XPI.ANATORY I,ANGUAGL CounlS' �� enter i � tha � ore�im dionrd propert• for inspcc �n i posc< G Sifr .i.�.I<<t U�IC v . . . �� .' ` . , . . ., • . . N . ` - . _ , 'D - � � _' i _" . , . ' , ' ' . .'�J �_ � . ' , N , � •�' . Z . . O ; I ` , � N - •i ., � �_ ' � . � . r - � , . ' � " / � �� . `i � . N ro , m . C: - -i O (n O . 1 : - - c��n .� . ' • j�; - _.� 'I ' -- - - �- �r, c. c.. � , �` - • � •- �G - ` _ C.�i� _ _ - ' C 'l ❑- ` _�:_ - i c c �. � ( . .. - . _- _ ( f ` _ ' ~ \1'- F•�'_ = ;` _ T` \1' _ � _ � _ C �r � ' iJ . ir.. � - �` i r � � ; _ ;==_ :_ . -, = _= _ � _, - =__ - _ =: , - - - _ _ • ' . ' • � � �. _ `� _ n _ "= __ - _. __. ,. '~" �. _ - _ �,�: .. • , ' ' ^ I -. ` V . If � � _ _' ._ �_ -. _ ^ � � / i _ � C __ _ _1 � , � � ` �'[. " ` - !Z. , ' ' I i = ti C 1 ` _ ` � � � _ ` � •! ^ _ `. ` _ -. 'n • ' . � 1 : _ = ^ ' 7./ � - . , ; _ ... � . _� v -. _ �_ . - . �•- � ! � I � c.� - �' ~ ` _ ' _ ` r _ , �,.. � ^f •, '_ ' � - r,. . . .. - ._ : � j � i:. ' _ - _ _ _ _ _ - = `, _: � _ _ F = -_ �` � .rl� _ _ � . _ i , I _ _ �. = � _ ` = -. .- _ _ ' " �_ : - (. ^ , � ' I ' �_ y^ `. � � - _ f •_ ••� • _ � _• C./ �' ' • • I I I f �1 '. . _ 1 r-, ' . ` •_ ` n ` ^ ' .. ` � _ � `' r ._ � i � I ' 1 . :. -. . .. . � C . � .. ti . .. _. -. � ._ . � _ [: . - - V�i �`