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HomeMy WebLinkAbout1167A (5) l5"ORRIiItS'COStI'PNS.\7l0\DFCCLARAT[ON GEAB 8(2�fl01 APPLICATION FOR PERI�IIfT f hrrcby :�ffirm �h�t [ h���c :� rrrtificale of cnnarnt to srlf � 'insure,or z nrtific�te nl}q��rkcrs'Cnnfprnsation Intursnce,nr HEATING-VENTILATING-AIR CONDITIONING a cerli(i;d copl'�hrrrnT(�cc.ta00.I.al�.G) I'olicy\o.F �4329Cr,mp�n5 Fdll"IIIOIIt I ❑ Crrtified ropy is her���y fi�rnichc;i. COUNTY OF LOS ANGELES BUILDING AND SAFETY � Certi(ied aipy�is fiird«�ith Ih;counip IiuilJing inspection dep��tmrnt. FOR APPLICANTTO FILLIN 6UIL�ING n�te t��uc,m (PRINT OR TYPE ONLVI ADDR[55 1140�N. GO1dCn SpY'ings_Dr. cearttic:�Tr.or r.�r:r.�rnoti rao>i�coiea<i:its• NO. TYP[OF APPLIANCE OR EQUIPh1ENT FEE LOCALITY Diamond Bar, `iA Bldg, 13 CO`.1i`i:`!5,\TiO.':I\SIJI2:1\Cli NEAREST �. (7his �eclion Ileecl not nc cornplCteej ir�I�e u'oik in�'fJl1'e� A�SOFiP710N UNIT,BTU Cf7055 ST. ' d 0 hy the permit is for anc hunJred dall�rs (SIOQ) nr Iras.) o�5raicrNo. Paocesseosv V I ccrtify 16et in Ihc per(nrm:mcc of�he�cnrk for��hich[his AI(1 HANDUNG UNIT,CFM petmi[ic is<ued,I sh:�ll nn1 rmplog any permn in anp msnner `Q ��� O ui:is�o become suhj_ct in[hr.P;nrkers'Comprns;rtinn Lau•s. BOILER,f�TU �— MPROVALS AT INSFECTOR'SSIGNATU�E �U ���t� ��E'�1110°� 7 ICOAIPRF:SSOR,6TU�OyOOO_�_JO O ROUGH �� � � N ^%()TICC TO:\I'i'Ci('�1ti"f�: If,:i(tct�7.�kin:;thi+lertific�tc of 20 VENTILATION SYSTEh7 po 00 �a� Z ]irempfian, ynn chould b;come xcbject Sa the 14orArrs' o FtNAL Cnmpens�tion prqcisiunc nf[M1r Lshrr Cnde.you must forth- � �-- --J �si�n comply ,siih s�ch pmri�ions �,. c�ua o,•rm�c <n�n i,e IEVAPORATIVE COOLER VALIDATION Jecmrd rt�n�:zJ. � FURNACF:� FqU— ,�i ��TY_ I.ICI�:NSIiDCONTRA('T(IRSDGCI.:\RATIOV J FIOOR� BTU_��J��aO� 7O OO I hereby affirm thal !am licrn�^d unJer pn�cisionsotChspter HEATER: SUSPENDED UNIT Q�fcnmmrncin���ci�h crctioo^nnp),�r Uic nn 3 at lhc f�u.i- IVALL n^cv and Prnfe<<�ines Cndr.and my!icense'it in fult fnrcr an:l j `'"`•". 53 Registees_�l.l_5 � 9 �.�«•�t�xi�m�,��_380543^ �,;�.�•�;�ts_C-20 c����<<,��,�,Rancho_Air n�t�• 8-31-85. � 1 am ezempt frmn the licc��in.t requircments sc I am a licrnsed archi�rct nr u r.�i<tered profrrvinnuf rneincrr Plan eheck fee 254o af above. - aetin� in mv prnfe��inn�il c�p�cit� fS�ctinn ;ns�, nus� �1�1 67 A inr�s and Pro�r«luna C��dr). PERMIT ISSUING FEE S 1Q rjQ #. . . . .g 1.ic.�,r xrz.'�'�._ _n�tc TOTAL FEE 3..23 25 �io�ir.otC.`:7'P..RL'[LUi'K UPCLAi2ATIOV ALAN CHECK APPUCANT 1 •3 2'a 2 5 1 �trehy nf(iim Ilnl i : rm�t frum-Ihr Cnntractor's NAME • '3 2 a 2 5� Licer.ce La•.v fnr the fnPr��+nzcrr�!con (�er[ion 70315. Du�i- . . nesa�nd Prnl'rs�innc('o;f;:): noo�Ess � 0 1,2 4-8 4 � 1. ;�s i v��nrr uf thr rrnrrrtti.��i!t dn Rir��nrk �nA thr structurr is n�il intenJecl �ir offrreil f��r <:�Ir (Sec(ion CITY TEL.NO. 7044,pn�ine«snJ Prnfr�si.mc('ade). � i,�s��,,,���„r�r�• � O1''"��' THE ANDEN GROUP pr pert5'.:�m eccluci��_iy contrsctinr wilh license� cnnlr�,�ctiirs In cun�lruct ihe �rrij�c[ A1All A ' (Sertiun^04d,Bu<inrca:�nd Prnfca�nn•�C�+de). nDORES51�7Y P]1"�(1(�ey( C015TRUC7�IOV L]'SDIXG A(;CVCY CITY TEL.NO. � ���•«n>• �rr��„ u��� �n�•�:� �s ., �„„s«,��������IcnJinr ��ency Covina,_CA—(818)-967--9541 fr�r Ihe �+rrf��rm:ince n( Ilir �t•iirk I�ir ���hicli Iliis �e•mi[ is CONTF7ACTOR Rancho Air, Ine. it<ur:i(SCC.30v7,('i��.(;.). Lendet's�amr ___.___ ._ A�DRESS ggg0 Benson Ave. Suite 118 Len�lrr's.iAJrcS�_ ��TY Montclair, yA TEL.NO.(J81—(�HOZ ' � � 1 errtify th�t I h�a�•e ri�:�J tlii�:il'1`Iic.itiiin :in�l st�te iha� Ihe ^TATE 9 LIC. 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