HomeMy WebLinkAboutNo Permit Number (50) \VOIiKBFLS'C0�IPFNSATION nF,CI.ARATION 76A964C A P P L IC AT I O N FO R PE R M IT
1 herehy atPirm lMt I hace a ccrilficste of cunsent to srlf CE-878 f2-601 �
insure,orncertificarent��'orkers'Compensationinsurance,o� HEA7ING-VENTILATINGAIR CONDITIONING
a certi[ied copy thettn[(Sec,3P00.Lah.C.)
������Y r,P.WCI.08855Z����_HomeJns.
COUNTY OF LOS ANGELES BUILDING AND SAFETY
� � Certified cupy is hereb5'furnished. �
�Ceriificd cnpy i5 filed with the cpunty buiiding inspec[ion FOR APPLICANT 1'O FILL IN oUILOING '
ar �rtmeot. ADOFESS 1412 S. Lemon Avenue
�,t��J��3—���r,�,,,t Santiago A/C (PRIMT OR TYPE ON(.Y)
LOCAI.IT�-R. 30893=A_Lot_3_R.H
CGRTIF[C�TG�FEXL5IPT[ON PItO\tR'�RKERS' NO. TYPE OF qPPLIANCE OR EQUIPMENT FE@
C051PIiN5AT10N I^75URANCIi NEAR[ST }
(ThiS SeCllon nced nnt hC co[npl?tcd i�thc tt•prk int'olt•ed ABSORP710N lJN1T,OTU cnoss sr.Colima Rd. & Rapidview Dr. p'
O
Ay Ihe permit�is Cor one hundred dnilars (SI00) or Icss.) DISTRICTNO. nnn GPOCEf'EDBV � U
l certify that in the prrfnrmance nt the���ork(or��hich thle AIR HANDLING UNIT,CF�1 � �
permit is issued,I sh�il nn�emp�nY ony ptrxnn in nny moMer �
xo a5 tn hecomt Subject In the\5'�rAers'Compenssti�n L3�vs. BOILEF�.6TU pppROVALS OATE IN ECTOA'S51G"�ATUiIE (�
D3tc .�.DP��C9nt , COMPRESSOR,BTU�8__w_�._._ � � �"
ROUGH N
NOTICI TO AI'PLICANT:If,after making�his Cerli(icate nf VENTILA710N SYSTEPd � I FINAL �a' �.����,��+'�- z
lixemptinn, ynu shnuld hrcnme subjecl in the 1YorY.ers' J ,
Compensation prorislons of ihe L�bor Code,ynu must for�h• EVAPORA7IVE COOL[R VAI.IDATION ,
with rnmp�y u•ilh su[h P���'i<ions or �his permit sh211 be
Seemed te�'nked. FUFiNACE: FAU fi VITY
LICGNSIiDCONTRACTORSDECI.AIaATIOV �
' FLOOR' BiV_ � _��� ja �
(}�eichv atfirm that(am licensed under prnrisinnsnf C�apter HF,ATER: SUSPE�IDED VNIT .
9 (cnmmcncing with Section 7000)a(Di+'icion 3 nf the�usi- �NALL �
nett and I'rnfessi�ms Cod¢,and my lirense is in fuli�orce and �
�rc«<. 1 I �l_2� t_
License NumAer_LG�E LIG Class C=Zo
c���aa�io��antiago_ALC n��r 8-4-83
� 1 am eaempt from the liccnsing requtremrnts as 1 am s --^-'�.� t1,�A �
� Ilcensed architect ur a reFistered proftssionsl enRineer P�an check fee 2595 of above. � � �
ac�ing in my pr���essionsl capacity (Section vosi, nus- pERMIT ISSUING FEE S tO _D �•• •6
iness and Professions Code).
\. 'rn .�'�,��1C7.7J�
i.ia��r RrR.Nn. Date TOTAL FEE ��-j
HO]1H OICNF.R�IIUiLDEIt DRCI.AItAT10V PLAN CHECK APPUCANT � . .�.• +G.�.!C�u
1 hertby aifirm that I am tsrmpt fr�m-lhe C�>Mractnr's NAA1E '
License law far the fnllowind rrason (Section 7011.5, [3usi�
nest and Pro(eSsiOns Code): ADOftE$S ��,'� (�—n� \
� � i, ns n uf liie pruprrlY.•+'iii du liie work and ihe CITY TEL.NO. ,
struclure11it nnt intenJed nr ofteied for sale (Scd�nn
7044,pusiness and Professinns Code).
❑ OWNER
1,as nwnar o(the proP«�Y•�m esclusively 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.
CONSTItUCT10Y LENDING AGENCY cirvNewport Beach TEI.NO. '
I hcreby �ifirm [hat thrre is �construc[ion lending acency CONTRACTOR - � � �- � -
fnr [he performsnce of the �vork for u4iich this permit is Santiago A1� Conditioning .
icsued(Sec.3097,('iv.C.). �
Lender's Nsme_LVOfI�. P.ODF7E55 500 w. Rowiqnd _
Lender's AdJrtss arv Santa Ana TEL.N0.9S7-E>S6O "
[ccrtity that f have rcad this applic�tiun and stalz that the STATE UC. �1
ab��vr infnrma�ion it rnrrect.1�Free in c�mply���ith�11 Coun[y LICENSE NO. 269��I6 CLASS C-G� -�
ardinancrc anA State lai��s regula[ing Hrs[ing,VentilatinR�nd
Air C.ndi[ioning,and hrre �ouifin ire ttprcsrntati�'es of this. SiBF RF•.VliRSli 1'O1L F.RYLANATORY LANGUAGE - � �
Ciu tY lo rnter up Ih �b•.��menti�>ned pruperly for
�� ec�i�r��r�� •..
c -4-83
Signature of I'ermi ; Uale � - -- -
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