Loading...
HomeMy WebLinkAbout1337A (7) \1'ORRGRS�co��i�r.tis:anounr:ct:�n:�non � cE"-si°s�iz-�m APPLICATION FOR PERMIT � I hrrebY �ffirm Ihat I hare s certificate o(mnsrn� to scl( i . � � inrure,or a certificateo}Wnrkers'Compenvtino lncurence,cir " HEATING-VENTILATING-/11R CONDITIONING a certfied cnpy Ihereof(Sec.3R00,Lah.C.) . ' Pnlicy 4n. Cnmpany � • ' ! COUNTY OF LOS ANGELES I ❑ Crrt�tied c��py is hereby turnishe�. BUI LDINC AND SAFETY � Cerlified rnpy is filyd with Ih r mnty buiidi�g inspe tion -���rr�� 6UILDING p�/tment. FOR APPLICANTTO FILL IN qODFiESS � 1)ate�f�=a�.l�irlicnnt ' _ _ _ _ IP(iINT OR TVPE ONLY) - . LOCALITY�,�L ��r CGR7IFIC:ITL OI"EXES11'TION['R0�714'ORKGRS' NO. TYPE OF APPLIANCE OR EOUIPA7ENT FEE COSIPLNSA710N INSIIttA!2CI> . N[AREST .. � � Mv� a (This section nced�not be cOmpletcd if ihe �carA involved � A650RPTION UNIT;BTU CFOSS 57. i-� b}' [he permit is for one hundred dollars (51(10)or less.) �� � .. I DISTPiCTNO. PFCCESSEDEY . O 1 cerlifY����t in ihe pertnrmance ot Ihe u�ork fnr«hich�his i 111R HANO�ING UNIT,CFM11 ' /� � w `�� O permit is issued,1 shdi nnl rmpluy sny prrs��n in an�•manncr �j� 1V� so as m herome subj=ct tn the\Vnrkers'Com{+ensation La���s. BOILER,OTU I I— �� / � PPPROVALS DATE irvSrECron'SSiGvaTU�e �U Date Applicant � j ICOMPRESSOR,E3TU_b_�r�0 �� � qpUGH a NOTICI'TO AI9'LICANT:If,after maAing this Certi(ic�tr of � ��-' � F.rem tion, VENTILATION SYSTE�4 FINAL �_� ? p you should becnme suhject to thc 11'nrkers' I Compens�tion prarisinns nf ihe L�har Cnde,yn�must f��rth• [V:,PORA7IVE COOL[Ft �eith camply �cith sueh provisinna or this permit shall be I VALIDATION � dcemed recnkeJ. FURNACE: FAU_�GRAVITY_ � LICFCNSISDCOVTRACTORSpi[CLARATION Z FLOOR� t3TU_ �p�00�- �C� 1 hereby affirm that I am licenced under prmisionsofChaptcr HEF�TER: SUSPLNOED UNIT � (commencing�rith Srction 70D0)nf Divisinn 3 of the Busi- WALL - � ness anJ Professinns Code,and my license is in full(arce and �: � �rre�c. Z�7 ` �2a C�i'2/ �-- e.�►ti�rt e cS:u—����d C�- �� i Licenae Number. /�b . Lic.Class.�r _�/ , . � Conimctor i���� Date�l>�� � ❑ : . . . . . , . � . 1 am exempt from the lirensing reyuiremen�s as 1 am a licensed .vchitect or a registered profecaional enp.ineer ' Plan check fee 25 0 of above. � . actin� in my professinnsl cspscity (Section 705I, [1ns- � � inest�nd PrnFessionx Code). PERMIT ISSUING FEE S s d :=� J�7}� Lic,or Iteg,Nm Datc TOTAL FEE I O� � i!" �i+ •Cl � - H0�11i U\5'NLilt-RUILDFR DECLARA7(O*I � ALAN CHECK APPLICANT - Et ' � �i 3.F C I hereby affirm that I am exempt from�the ContractnPs NAME � ��� ��Cj���x License I.sw for ihe follo�cing reason (Sec[ion 7031.5, Pusi• . � - ne�z snA Prnfescinnc Cn�e): AOORE�S . ' 'O 9 '� '��_�, � 1,as�n��nrr of thz pmprrty,�vill dn Ihe�eorA and Il�r � s[ructure is no[ intended or offered fnr s�le (Sr�tinn CITY TEL.NO. 7044,Rusiness and Profcssion5 Cude). � � I,as o�a�ner of the property,am esclusive�y enniracting OWNER �v����S � P��� ��-ith licenstd coNractars to canstruct ihe project MAIL �'7 (Src�ion 704d,iivaine�s and i'mfr«innv CnJe). AODRE55�LDrj.�Z ('�L/MA ' CONSTItUCT10N LGNUIYG AGF.NCY CITY��QL�(�a7— TEI.�n'VO. —��a�� . ! herehy affirm [hat ihere ic a cunstrucliun lending agency' �Gy /� �� for the perfnrmance nf ihr ��vrA fur �vhich �his permit is CONTFSACTOR �T±� . issucd(Sec.J097,Civ.C.). ' ' � Lender's ti�me ADDRESS /�/,�� /`_ /.y� � � - - - ! [ TC.�'��J f✓ LendePs AAdress CITV� / / .1�/� TEL.NO. J� . , � 1 certify�ha� 1 haee read ihis application and s�ate �h�t �he /� t.t�'•., /7 9�z=�-�y i ❑huec information is cur�ect.t seree In romply�cilh nll Couniy L C NSE NO.��G���7 C AS:�j`�2���'� � ordinancrs anA State laa�s regulating Hesting,Ventila}ing and - � Air Com�'tinninK.������herr6y authnrize rrpresrntatives nf[his � SGG itFiVIiRSIi FOIL LXPI,ANATORY LANGUACE Count fo enter ipnn Ihe �mee-mrntinned pruperlv fnr � �. insp�.iinn purpo• >. ' � �/7-� �•n.,wrca,1'erru..ire U�te . � L . T ��� - �4 l . � t . - •. ! • , � ,. .� ',�i �Y • � 1 � l/ ,"��' ' . � . r ,' . -NO „ • • =i� � m . � , •�y. p , � � 9 N Z O� N • � ' . Z N _ ,0 . `- � �', , � .- 9 " ' N � ' ' p , . a . . �� ` ,. � "� -: _ . .� ` J' ' '.. ' . . n , ; . . , , . ' �� ^ `�. . -�� � �,s C:'Y',r . ��c a„ c'� _•.. � , . � 'c n�� �`v'" ==�tio;o c �=o _.% n v� '� � ' h C p �G h r. �Qrh" ^� O w w n "'�O�� � ' �• ['� i.� C`^O �'� "� .C.i•.�1^ :� G.^'^ _ p Y.O r: v� n ^� N v� c;N!. C'C ro�O 't,'.v v. C „' c% rt, i.."p G.�� � T n.��.� � � � • n .� O � �.�� ��'Y. .. n.�l.i �p V'~ R. ��fa Y.p �+.i� V `�': � � O C � w'�' �' : T�`_:..n ,..i �C r - ^ =� « G " � ♦ � � ' nV � ~t�� v. g ,�^ 1 G� Cr�.�.G :. T= p^^�N' V:C,C'C�lr r�: h � � .. N t„C y O =" �, : ^ '^ ^ `.a r'' c '.� ^.Q v �' � � e% N ' .r1 p!' '/ "� C r! i"�'�' Q R C�G N h v� i 'y;`C W'^ G C'ry�' 3. 3 C p ,�.,' !�'. LJ O •' I' /� �''� ...�'C�' ^y � C -•'C � o : � p c' v�C r'1' �1"""'+^, " �r '� � 'e. G, „ p 1 C � . r.+ n f � � c�' p`-_ c��^ �.;,��_�,� �.� �-`�` ^_.c, �o" '_� � v � C' C � ='c'. . �- " -�. C.�� � C -C n`p�•^.��.C•C? Y� O � /` � � G �`�c r"�" �i- ^—�. , ` "' �,.- ' � " " � o� '" " � -`� 7 � Y � � - ^��� cn .�- � � - o �' --�� �-r �= a G � �'"N ~' -:� ��o°r'� •• ^�� ^' ... - i '` �` �`� `- ~ �i s "'„' � � - 'C' •^^ .�.,C v� �t • ^•~ r�O Q' C b �.'C �. r. v.Z,Sl.P �•r i � v' ri � ' j r � , i:. t ''ty v� G"I' ._. ra " h .� 'R' f"✓ C '7 , � cl� e^�:.'c c � i � �'<. c N t � F. �,u K ,_�' f. c :� � �= � � p � 2 �� v�. .".'� "f n C C� G _ »'=. �: C n "�� � �' C v'C '^.i f V� � - �': O y� !� O�-..a C1� O Q O A n C �� C ''S, � �.~~.C a n n r .. � ^ � w ta^ w=��v C ...G, . . t"� �.`' '� v. t, + r � _� " :. i p c� G X O :�' �> � tn v, Ta .. Ca I"��:� • 'C G G tS ` C .-\ i n� n"'t �` �; R'�' . .._r � C �^�t C �� � C �� � ^�,,. _ �y 9-+.. �� p �` . , c Q � '' �,. �. n /• c _ ,. „". - �r. c �, n c: 6 � , ^• c � � �c �. c G Q �A G r, �� C�^i'�•'• � C J� . n� C �• � va `J � � � . , �C,T" i''��