HomeMy WebLinkAboutNo Permit Number (49) \VOIiKBFLS'C0�IPFNSATION nF,CI.ARATION 76A964C A P P L IC AT I O N FO R PE R M IT
1 herehy afPirm tbal 1 hace a ccriificste of cansent to srlf CE-878 f2-60) �
insure,orncertificarent�t'orkers'Compensationinsurance,o� HEATING-VENTILATINGAIR CONDITIONING
a certi[ied copy thettn[(Sec.3P00,Lah.C.)
������Y r,P.WCI.08855Z����_HomeJns.
COUNTY OF LOS AIVGELES BUILDiNG AND SAFETY
� � Certified copy is hereb5'furnished. �
�Ccriificd cnpy i5 filed�vi�h the cqunty building inspec[ion FOR APPLICANT TO FILL IN oUIL�ING '
ar �rtmeet. ADOFESS 1412 S. Lemon Avenue
�,t��J��3_�r��;�,,,t Santiago A/C (PRIMT OR TYPE ON(.Y)
CGRTIF[C�TG�FEXL5IPT[ON PItO\iR'�RKERS' NO. TYPE OF qPPLIANCE OR EQUIPMENT FE@
LOCAI.IT�-R. 30893=A_Lot_3_R.H
C051PIiN5AT10N I^75URANCIi CROSS ST.
NEAR[ST
(ThiS SeCllon nced nnt hC Co[npl?tcd i�thc tt•prk int'olt•ed ABSORP710N lJN1T,OTU Colima Rd. & Rapidview Dr. p'
O
Ay Ihe permit'is Cor one hundred dnilars (SI00) or Icss.) DISTRICTNO. n GPOCEF'EDBV � U
l certify that in the prtfnrmance n(the«�ork Cnr.chich ihle AIR NANDLING UNIT,CFM11 � �
permit is issued,I sh�il nn�empiny ony ptrxnn in nny monner �
xo a5 tn hecomt Subject In[he\5'�rAers'Compenssti�n L3�vs. BOILEF�.6TU '}1 pppROVALS OATE IN 'CTOF'S51G"�ATUiIE C7
D3tc .�.OP���ant , COMPRESSOR,BTU—l�O-VK-.-- � � �"
ROUGH N
NOTICI TO AT'PLICANT:If,after making�his Cerli(icate nf VENTILA710N SYSTEPd � I /f� r "?Q�j�� �f z
lixemptinn, ynu should hrcnme subjecl in the 1YorY.ers' FINAL ��
Compensation prori�ions of ihe L�bor Code,ynu must for�h• EVAPORA7IVE COOL[R VALIDATION ,
with rnmp�y u•ilh su[h P���'i<ions or �his permit sh211 be
Seemedte�'nked. FUFiNACE: FAU fi VITY
LICGNSIiDCONTRACTORSDECI.AIaATIOV �
' FLOOR' BiV_ � _��� ja �
(1�cichv affi�m that(am litensed under prnrisinnsnf C�apter HF.ATEft: SUSPEMDED VNIT .
9 (cnmmencing with Section 7000)n(Di+'icion 3 n(the�usi- �NALL �
nest and�4nfessions Code,and my lirense is in fuli�orce and �
�rc«<. 1 I �l_2� t_
License NumAer_LG�E LIG Class C=Zo
c�„c�a��o��ontiago_A/_C n��r 8-4-83
� 1 am eaempt from the liccnsing requtremrnts as 1 am s --��-'��� �1,�A �
( � Ilcensed architect ur a roF�stered proftssionsl enRineer Plan check fee 2595 of zbove. � � �
W ac�ing in my pr���essionsl capacity (Section vosi, nus- pERMI7ISSUING FEE S 'Q _O �•� ��
ineu and Professions Code).
\. ,r^
[.ia���IirR.Nn. pate TOTAL FEE rtsj I'•,•l!G,`J$
HO]1H OICNF.R�IIUILDEIt DRCI.AItAT10V PLAN CHECK APPUCANT � . .�.• +G.�.!O u
1 hereby aifirm that I am tsempt fr�m-lhe C�>M*actnr's NAA1E '
License law far the fnllowind rrason (Section 7011.5, [3usi�
nest and Pro(eisions Co�r): ADOftESS ��,'� (�-n� \
� � i, ns r� uf liie pruprrlY.•+'iii du liie work and ihe CITY TEL.NO. ,
struClure11it nnt intenJed �r ofteicd for sale (Scdinn
7044,pusiness and Professinns Code).
❑ OWNER
1,as nwner ot the proP���Y•�m esctusivety cnntracting 3r.esley
n•ith licensed contr�ctors to conctruct the pmject MAIL
(SecU�n 7044,�usiness and Pmlrssions Code). AOD�7ESS 4600 Compus_Dr.
CONSTItUCTIOY LENDING AGENCY cirvNewport Beach TEI.NO. '
1 hcreby �itirm [hat thrre is �construc[ion lending acency CONTRACTOR - � � �- � -
fnr [he performsnce of the ��'ork for ��4iich this permit is Santiago A1� Conditioning .
issued(Sec.3097,('iv.C.). 500 w. Rowiqnd _
Lender's Nsme_L�lOfl�. ADDF7E55
Lendtr's Addrrss arv Santa Ana TEL.N0.9S7-E>S6O "
[ccrtity that f have rcad this applic�tiun and stalz that the STATE '• UC. �]
ab��vr infnrma�ion it rnrrect.�aFree in c�mply With�11 Coun[y LICENSE NO. 269HI6 CL�+SS C-L� -�
ardinancrc anA State lax�s regula[ing Hrs[ing,VentilatinR�nd
Air C.nditioning,and hrre �ouifin ire ttprcsentali�'es o!this. S13F RiVFiRSIi 1'O1L f?RYLANATORY LANGUAGE - � �
Ciu tY lo rnter up Ih �b•.��menti�>ned properly for
�� ecsi�r��r�� •..
c -4-83
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