HomeMy WebLinkAbout0897A 1t'pRK1iR5'CO}iPTiNSAT10N Df[CLrVtAT10N ` 76A364C A P�'L IC AT 1 O N FO R P E R P�I iT
1 herehy affirm th�t I ha�'t a ctrtifica�e of cnnsent In self i • CE-fl1II(2�60) �
insure,ur a certific�te nf\l'orkrrs'Compensation Insursnce,oi �I . � ' �-IEATING-VENTILATINCa-AIR CONDITIONING
a cer[ified cnpy ihereof(Sec.3800,Lab.C.)
Policy Nn. Company
❑ Ccrtitied copy is hrrehy turnished. COUNTY OF LOS ANGELES RUILDING AND SAFETY
� Cer[ified copy is�lyd�rith ihe cnunt}'building inspection (3UILDING
departmrnt. FOR APPLICANT TO FILL IN
aooness /'� � ���_[��
Date Applican[ IPRINT OR TYPE ONLY) �r
LOCP.LITY /.��� /
CI�:RTII'ICATF:Oi'i:XF:\1PT10^I I'RO�f\VORICI:RS' NO. TYPE OF APPLIANCE OR EQLIIPA1ENT FE[ ��yr(i/1�✓/G /uz^�
CO�iPENSpT10N INSllRANCE , NEAREST }
(This S�Ctioq need nnt he Completed if il�e «'Ofk involYed AR5017PTION UNIT,FiTU CRDSS ST. O
hy Ihc permit is for one hundred doqars (5100)or Icss.)
GISTf11CT IvO. PFi0CE55G�B" (�
1-certify ths� in Ihe prtfnrmince of the u�ork inr���hich thic �11ti HANDLING UNIT,CF�q - / �
_ prrmit is iscurd,1 shali nnt empinq:�ny person/'�y�;my manner �� �(��.�i�/ �
sn,�s ro become subjec�to the 11/'/��.kers'C�m/y// tlon Laws. BOILER,BTU�_���asod f- --
/ G( / J// / / � MPF{p\/Qli �l1TE ���SPLCTOR'SSIGNATU4E W
D�1e_��'_a,'PPlicanf�! /lE'i. !A'_ _. a
( t/�`�"`�v�•�-� COMPRESSOR,BTU RpUGH y
NOTIC}:TO Ai'PLIC.\NT:If,a(�rr making this Ccrtificatc ot VENTILATION SYSTEId FINAL 1�y�� ����'��v ?
Gxemp[ion, ynu should becamr subject In iLe \\'nrkers' (
Comprnsation pru��iaiont qf[he Labor Codc,ynu must forth- �
�cith cnmply �ci�h such prm•i5innc nr Ihit permit sholl be FVAPOFATIVE COOLER � UALIDATIOiJ
deemeA revoked. FUFiNACE: FAU-GfiAVITY_
LICL\SED COtiTRACTORS I1GC1.:1IiATIOV FLOOFir 6TU
1 herehy�ffirm th�t 1 atn licensed under nrnro�isionsofCh:��ter HEATEFi: SUSPEN�ED UNIT
9 (cnmmancinR�vi�h Sectinn 7000)nf Division 3 0(the I�usi• WALL
ness and Prn(etsionc Code,and my license is in tull force and
effrct.
Licensc Vumbcr Lic.Class
Cnnlractor nate I
� I am exempt (mm the licensing requireinents a5 1 am a
licrnsed architect or a registerrd professional engineer p�an eheCk fee 259'0 of�bove.
aeting in my pmfecsinn�l capscity (Sec[ion 1p51, Ilus- ' .
iness and P�otrsslons Code). PERh71T ISSUING FEE S �j(J ?0 a 9 7 A
Lic,or Reg.tio. Uitr TOTAL FEE 3+��Jl� � •
;t. ... .i:8
HOS1Ii OR'N1iR�13UI1.ULI1 DfiCl.:\R.4TfON ' pLAN CNECK APPLICANT �
� �;• •33.5�
I hereby aCfirm that ] am exempt frum�the Contrector's NAME � �
I.icensn Law for the (ollo��•in6 rtasun ($eqion '03I.5, pusi- •'� �J��O U
ncss and Pmfecsions Code): qpORESS
❑ r. n��,�.-„r� „r u�r pr„p��ir.„��t ao me�.u�k a�,a wr :I 2C3-8•1 .
structure is nnt intenJeJ ar uffereA for sale (Sectiun CITY 7EL.NO. � .
\�y+7044,Ilusinrzs anJ Ptafessians Cade). �� A
VI I,�s ownrr of U�c OVINER /L//�H ��?��d
propeny,am C%CIPSIYCIy COO(�3C110s ��
�������ill� license� caniractors to cnnstruc[ the �rnJect MnIL L,..,�
(Sertinn 70a4,�ucinesc anA 1'rofessions Code). ADORESS �7���I�1*i'�^J��{1¢ (
CONSTRUCTION LEYUIiiG AC4;NCY CITY TFL.NO. �� y'/
I hercby a(firm Ihaf [here is a rnnstruetion lending agency �j���Ci1Q ��r� �"-'�-�`z/
fnt the perform3nce of the �vork for �rhich thix prrmit is CONTRACTOR OW�e�`� __
issued(Sec.3097,Civ.C.), —
Lendrr's Namr A��RE55 •�
LenAer'sAdJrcsi � ���'• -' � \ - '
CITY TEL.NO. � -•. � . .. , . , . . . .. . . '� '.
1 cerlify �hat f have read Ihis appiica�ion and stale Ihst Ihr � �
ahoce inFnrm�tion ic wrrect.f sgree to eomply u�ith all County L CeNSE NO. cLn55 .
ordinances and St:ite lows regulotin¢Ileating,Vrn[il�ling and
Air Condi�inning,and h+rehc�u�horlie reprrsentstices of ihis SICT RGVGRSG POR EXI'L.INATORY 1.1VGUAGR: � -
Coun+ to enter uC � thc aboce-menlioned propeny (or �
fusp ��� purpoces.
�(/� � ��—LZ-3� �
'S�gnaWre��l'Permittre Dste
\
� _.. �
�� - � � ' " , .
Z �, . :
� � . � -.
m � .. � ,
� �, � � �:
G� `'�+
� x
N
� x
0
m
N
`�
� � �
� : �
O
�'A , . 2
C
• � �
r N
. i. `
.
� c,C' ..
- �, C___ n
0
^^= n'; c':• y- � `�, ri
-- � ° c 'c
� ..N r f.�.l.r�,`� � J.S. .� �yCa �"� L.
. • ' " �• �� p� :. c� � " rry < r•' �=
: c G r.• 'r - ' "=i �:
C"�"`G � ` ��.,�'ti t� •�.C'`=y� _ �; " � � `n „
•. _ c=- _ ,;c�• '. � =�' ��.V=-T'rp ' G
�-�n.�.^Q.�C v, _ C : v, ' A..G•�:� �..rt •/''" �-' � y `��v, ,i•
� = C. � n e=. .� v ,;,;i �' C .. t-•i- 'c, ti�.�, � V �' ,..
^ ., i' - �.' F-� ^ �: n� �(�
7. �' ' �C ti= :�� G G � =, " � ^ G - . ^ `'L�-�% - �" C.�:. �:1
' C.R ,��'� f. .C � i= f N Rn� � ' I ✓
' .» ..��'v� .. �^ c�• - .��. `r � ,..�t'� . �. = . ^ �' G�� �..
' � r : .., . �o� G.V — '.'_ `% c�^ -, '%'%.;J:., V_ o .. z —n �-1 o r,:Y'� �
C ....,f. l.'.J .: ._� (c - '_ �C'a �'.. � .I � w'^ . G �+ ^ _�. �,"�
G �/' f. _ •G f: �r — G �'. c, ��.f.JG o v~ ^ C . � _ �r n
G "' / �-� :• G ' " = - - - . _ �. '' ' � N�' `' �-^ !. .
c_: �'— n G_o" v
t. � �C'; �� n� r..: �. c �_� - _ ��^. % �-_ _ z^���c :'
frt ' �^ I � .-.i !'. ��„ C+� � �:��: � r,��, R ��.0 i.N �G " �
� � r' �;T .� r. - .._,5:�.� �-..� ✓ SP.�. - G.,'J V.r .�
' i r/ � �. ._.f.'i ..�G� _ _ C. "'(.-, % 4."..,c-' ~ .-rt'� �.�� - ".C� .r✓
�. �� - R, = '` •^.�c: � G r: '� ^..f"T c - c � !�
, �.' Y — �, .'.�' � ^ _.':: �n «p ,�� �.,- S Y. ;� �., � = :,
' :'. ff t"' _ c C i� yG.:. �' ..,. fr v. �l r'�'�G - —C i, `��
. �, ^ ^'�., .��. �} .. �, .. : ~ r.1,., � ^,� 3 n O �
� . � \ L, !: -� C. 'v C T.-- h' � ^ ,-v i C C... `^ "� p �^.G..
� /� `' ^ c '�• �.C� _ .o o r• ��.• _ C,V '"n c..�..i, G '. ��� .
i. c ! v 7 i � � ��.� _ " � .^ C � v
. c : " („%�' � ^� C � C �. :: ., n' _ �` a n • � ./�/
� � i. ��. C G C. C �.. S. .p.' .,p w
- •t. C t�� r f "^" r '
, ' G p . `� . ` � _ C'�. � v - ' �,/���
� _ r v. C.� C � . /
�- ..j f: C� �-w C'c� - C G _ G /.0
. _ r. - — � !•�_ - �
� r-� w C, y
. ' r�l`�G io ' �i
• '_ f /,i
` ��c`^': /'!`
��i
i
.` '//�
• �' : ���
• �/��
��
. ��/
. /
'�"-.-,�i
/�