HomeMy WebLinkAbout1285A W'02K 7tS CC\iV}�lSA7I01v DI .L RA'll0\ � M16r>364C �g q s�'+p �w,� ��� ������ 1 he:ehy af( m cn 1 na�e a cer a ate ,S���ns nt to se�£ .... . �E�8'SS i2-80J . �3`��»,.�i,r P'@���� . . � tn.ure,or a c t t te uf work•;rs'C<inp ns tio i Insusan;:a.cr � � , � � }a,�p§�+�`�by�.t,���g���q-�-�N�y_��� �+������OORd6Nia n certifi�d c�,py chereu£.�(Sec 3F;00,Lsb ( )- � � . � � � t�:>i��>No.�4�..-�2.c�;,,�:���y_�t.ate_C�an�,__In�_.Fund ❑ Cert:fiedco �Q11P1?Y OF Lt'a5 G,�CiEL�$ � �y is hereby furnished. Bt31LD8NG AiV�SQ,fETY . .. � . , .��� �4� aDDFESS L Ot 3g . . . _ Tract 35742 L I {ertlfied cc �is fii d "cf�th�ctJ�ilTy'huil�t� .�*sss�mm�...�-n. -.'•-.n.-..�.-�-�m.,,...a _.-..... �,,,._:::�.� . .,...-,-.-.- n.,=�-' .- - .. .,....,.,�--_ r �insprc.icn FOR APPLiCAR9T TC)F9LL i� 3ui�o�t�c � `�' de° � 044 Lake Can on ��n Datc�j1�J�E3:pe1i.,,,� �u�ntfiit .heet Metal Co ,va���-iQRTYP�OVIYI . -_ --_ . . y._.- _.. . . ---- _"___._ �__- `�._._-�: . . . . . .. . . , . . .��_"__-T_'-_.— ,. .. .. IOCA�ITY . . � GLRTIFICA7Y;0(' -'Xh'viP`;-ION�FROMWrJRKliitS'� . �10. �I?YPEOF�APPLIANCEOREaJI?vtENT. ; FEE �_Y..._..___.__..._'_—_-.___ COM1 YI;NSa'I 'J'�-"ti�UR�`�CE - ..,-�.. _._--- - . .., + -j,-'- YeAREST � ... _.. .. y (1�;tit Secti�n rteed nqt �e campfeted Ii,Qhe W07�c tt1001vea � �A9S0 PTIONUNIT STU__ , � CRe7S55i. . tY the penri4 �s ''or ure nu^�dr>� doil:,cs "�1Q@ or i ss. . '��_- --- - .. -. ... "" ..�.",..",-.-.�..-,-,-•..,�". V � �� Z � � � � �� � ��- DISTS�iCYhO ���L�PROCE�SEDE� I cer[i;'} that n tiu perTorma[ oT thz work t I ch fh's .4 fi FSHhCLING UNI7 CFM, � �� � /� � y�ermit is icsued�( .hail��ot M'�IOj ARy V�non n�ny n=r � ��~�- ��� � 3 /����^����� � so is io Frzcc.�nc sub�ect.n the Nork;;rs'Cumpensa.i�.n(_a�vs. �eO�LEP�BTU_ � ' � — �._�1� C= --� o . .. ' ..- — - ..'- _... . .. � .� ! _ .. ��. F� APPROVAi,S � ❑AT +:SP� TO`SSI^'VATtJRE U D tc App:;cant '- --' �J�NT LArOR STU ._ _.._ I ����` ,iy � � _ — '— - _-'--�'-{— .:fiOiiG ��� � a. � �OT1CF TO 4PP IOANT If :tfcer mal n�S:his Certif.ca[e of , . . . . , .�!. ---. -- -}-..—���%�... ..JAPORP.TIOVFSC.COLER�. —'��. � � y !>.��.m� u , } .houtd oz �Tne sub u to �the t4u�ker;' Z U �Q =iNAI r �—�3� �� � -z Cn rpematiun p.o.��isions �'' iz E�Lox Code,Y�u rnust�crrh . ' - -- � ,��-���..—.. ��J-- � wiUi ccmpi} w�th such pr,ro�s�nns or�th�s,permrt sht�❑ b� , i �� VALIDATI�N deamadrevok u� � � � FURNA E� - FAU � GHAVITY __��i � � ' � - � � itCl'YSL!)CONTRACTORS IlLC1.RIY a pti. FLc70 ____ 9TU_._ � �.._' . . . � � I herehy:�ffirm that I am ticeils2d xr.Uer pr�vi=,�on o4<:iiagte: ���{�R?ER- SUSPf_MUEO J�I�T I � . 9 (c�m�:eneingwi[h�Seccios:^0001 nf ilivision�3 o`4iie}3usi.. - -V,lA�t.. .. . .. � ' I . ness and Vrofessions Code,and my licertsc Ss�in fu:i fr„ce and "'�--'-"—""-`""--�� - �� ��- -'�- ��" . � . � . . ef'tect. - . - . . . t:censeNumher 1°5932 . �.;�.e:ias. C'�t�..________ -- ------- --.-_.---.-i-�„ ._. , Convi�ctor SllII�t!�lt �1+'= .Date $ 16��� —� �--�--�-----��--. �� �---..,..._ ...---�� T--.. .. .. . .. . . . .. _ . �—__-. .. �—__-__—___ . . . . � S am exempt from th . . si g reyu�rem nts as I arn a . -__ _- _ __ _ ;�;�- . � licemep architecx o a e ct ed profess o iaF engina^r p��n check fee[5 Of eboV� _ _�+ I . � u tu., in mg pro?SSiG si c:ipac,tY (SecL�n 505t, Bus-� . -�-�--. . . �.� 2 V,V� netiiu��d t'�ut'essiunsCud.). �ERN!!7�SS't11NG FEE�I iL5 $Q , � .--- �--- --- - � o a S2 , e C, or Cieg.'Itio._� Date -- _ i _ ITS��'+4L FEE I iy jp� fi a HGRSF O4�Ni�.2$.IC C'k,R DLCLA.Ii.a IUh PLAh CNEC!<APPLiC 4NT � ' __� - i � �.7{`1 1 he��--affirm [hat I a i- eeemp f om-the. Y.r,t;uct���s -NAM6 - - � e _ � ��J i;a Lc,ns a.,�w Fur tha iotlowns rsason (Section �oss.;, ��..;- Sururit Sheet Metal Cq.s 11C _ a � n >sanai�;ofesti�o�„c�,de�: anoa� s 2181Z T3eSsIiire St ! _ _.._� �5. l y—'33 ,—+. � [, ;ss n�ner nf tlie prppert��,wsll dC the u:ork and tiie " '-- -'--_ ��T_L.NO. ..,. . . . . . svu:?ure is�nos int n ied u �fferecf f r :a1e (Sr,ct e n. C:TV Nac azxan Garc�ens � 527 886� ' 7044,Susi:iessanA rrT s oiz C<de) i1j J $TOCL' Fs.S ....- - . � � l,as ow�ne-of!he p p .t . ri �lus eiy cc,.itracti y OVl\ER -� ��ORS�_ITLC :,-,Li, i,�P:,see ;�,,tr..�:�„ c�, ���«�f„<.. ri,e P.�,;e,� nnai� ].6g8 Greer.briar Lane ib22�F � Section 70R4,susi�essand'r•:uf�ssonsCode). ADDPESS s ____'__'__'_--.'___..� .-.��.' "___"_'� C'Ov�2I2 iCTIUN Li�:'.VUfM1GAGL•NCY� GITV ]�YH8 l'c N[1. ..�SZ4-fjZ�� I harehy aff r n th at thzre �s s co� truN.ion lei na Br.ncg � --'� .�'�-��- --'`------ � � D. � . . . � tor ih pertorm.ance ff [he u•cri< �or xh7�h_ h„ parmit is CON RACTOR SllIllSP.2C. S17PEt �Ietal,Co., I.I1C.� � � � � �ss.�ed iSac �3047�(;iv.C.). - . ___ '�. _ -_ _.. . . ..E�a�rS va„e __�_ ___ Aoo��ss 21811 Belshire St ___jf L�narr•s.�avr�s�------ ------ — c�rv �a�•raizan Ga.rdens Te._.No 527-8863 A r c' I fy that i hui�e reacl this acp]- ,�[���n anG s[ [�tr�nc the STA7E � � ��� LIC � ' � � � a,c.ce inform�t�on�s ec,rrect.1 ul•tGe[O Ln�iiNic tlth.II County 'LIC._NSE N(�. L�S�3�L CI ASe �'-�F3 .--•--.�... �sw�..�-.��...�.�_�,-..�.�, .e.,� ,._ _...>.. � or irvnces:mG Stnte laws rey�llating He��in�.Veivilanng and . . . .'. . .. - . .- . .. . . ... . . .. . . . A C di7�nin und'uarebyuu¢,o �entwned�ptuFerofc�3� . .-� , '. _ __iAYORYLAhCL�,4GE . Q m[� ta en�r uponP?he nbo�� .. StiL RF:�F:72S7�,I'OIZ XPLA, ...,,,, . ._ .. . .. .. . ...... . :. . . . . _. . � �tonpurpo s . . r _.���. e/iF s `'`5:��.���f t'�rn`'ie`���:,c�._-J_.-�-------. 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