HomeMy WebLinkAbout1287A woaxres�co�tveNsnrioN orcL.aa.anoN �EA a;e°,2-eo, A P P L IC AT I O I�I FO R P E R M IT �-
1 herehy affirm that 1 ha+'e a certificate of consent to self J�
insure,or a certificateof R'orkers'Comprnsatinn Insurance,oi HEATING-VENTILATING-AIR CONDITIONING •L�
a certified copy thereof(Sec.3800,Lab.C.)
Policy No. 306^82��mn��y State Comp. Ins. Fund
� ❑ Certitied cnpy is hereby turnished. COUNTY OF LOS ANGELES BUILDING AND SqFETY
Tract 32576 Lot 18
. �Certified capy is filed�vith!he county buiiding insPection eUILDING
d,e�P��.rt`m«�nt. FOR APPLICANTTO FIL�IN qD�RESS 1967 Peaceful Hills Road
I)a1e�L�4�L$�Applicam�llfiat�t�(7Qe PTPha� Op, (PRINT OR TYPE ONLY)
LOCALITV
� CHR7[PICATE OF LXGSIP7'fON FR09t R�ORK1i1iS' NO. TYPE OF APPLIANCE OR[QUIPMENT FEE �
CO�iFl:NSATION INSURANCE . NEAREST
� (This SeCtion necd not bc CompletBd if the NOrk inVoh•ed A6SORPTION UNIT,DTU CROSS SL y
by Ihe permit is for one hundred dolfars (SI00)�or IessJ DISTRICTNO: PROCES.EDBV �
I certif'ihat in the U
} performanre nf the work fnr which ihis AIR HAN�LING UNIT,CFM
t.� v ¢
permit ic issued,1 shall nnt employ any person in any manner Q _
so as to become subject to[he llbrkers'C�mpensation Laws. BOILER,BTU F
APPROVALS DATE Ir'�,CTOR'SS�GNnTU�E ��
Date Appiicant COMPRESSOR,BTU ROUGH ;�� 9C� y
NOTICL TO APPLICANT:If,after making Ihis Certificate of - v
Fxem tinn, 4 VENTILATION SVSTEM � FWAL -i �— ' r � �?
p ynu xhould become subject to �he Workers' Q ay �2 .L�
Compensation prnvisinnc of ihe Labor Code,you must fnrth- � EVAPORATIVE COOL'cP
with enmply with such provisinns or this permit shall be VALIDAIIQN
deemed revoked. - FURNACE: FAU—GRAVITY.
LICIiNSED CONTRACTORS DECLARATION FLOOR: BTU
I hereby affirm[hat 1 am licensed under proeisions ot Chapter HEATER: SUSPENDED UNIT �
9(commencing a•ith Section 7000)of Division 3 of Ihe Busi- WALL
ness and Professions Code,and my license is in fuli torce and
ef@ct.
License Numfier 195932 Lia Class�-43 �
�' Summit S/M 8/I6/83
C�aclor Date
� am exempt from the licensing requirements ac 1 am a �
licensed architect ur a tegisterrd professional engineer PIBn ehOCk f2e 2540 of above.
actlng in my profe�sion�l capacity (Section 7051. Uus- � �� `�g,`�a
iness and�roCessions Code). PERMIT ISSl11NG FEE S IO 50
t.ic.or Reg,No. Date
TOTAL FEE 34 0 #'.' ' ' �8
HOM11G OR'NTR-Iil11LDkR DI3CLARATION pLAN CHECK APPLICANT I • •.3 t�..r7 O
I hereby aCfirm that I am esempt from-Ihe Contractor's NAME Sur.mait Sheet Metal Co. Zne. ••' °���•J��
License [,aw fnr the foilowing reason (Section 7031.5,Dusb �
nessandProfecsionsCode): _ AD�RESS z1811 Belshire .St. � p81 9—II3 �
� f,as o�vner of the ptoperty,�rill do the�vork and the dTY TEI..NO.
xtructure is not intendrJ or uffered (or sale (Section Iiac�aiian Gardens 527-8863
7014,yuc(nrss and Prnfesxions Code). — —
OOWNER M. J. Brock � Sons, Inc.
1,as awner oC the proPerty,am exclusively contracting
with licensed caNractors to wns[ruct the projeCt MAIL
�sea�o��oaa,pusiness and f���ress���z c�ar�. nooRess 1698 Greenbr.i��Lane,, �?74
CONSTItUCT10N LENpING AGENCY CI7Y Brea -re�.rvo. 529-8I70 . .
I hrreh}• affirm tha[ there is a rnnstrucNnn�ending agency . '
for the performance oC[hr �vork for e�hich this permit is CONTRACTOR Summit Sheet tfetal Co.�_IAC. � � �
i55ued(Sec.3097,Civ.C.). . .
Lender'sNsme A�DRESS 21811 Belshire $t. - � �
Lender's Address � CITV Hawaiian Gardea�TE�."o. 527-8863 �
1 Certify iha� I hurt read [hi5 application anJ S[:��e ihat the
above infnrmstion it correct.1 sgree tn comply�cith all County �icFNse n,o. . 195932 CLASS- r'-43 -
ordinancrs and State Ia�a9 rtP,���a[ing Heating,Vrn�ilatinR and _
Air Condi[inning,;�nd hereby su�horire rrpresentatives of this SF.Ii RGVF RSE FOR EXPi,ANATORY LANGIIAGF.
G unty tn enter upon Ih above�mentioned properly for - �
in�pectiun purpocrs. / . .
���i�,�8/16/83
�g eure of Permittee � Uste �
�\
�
...;
��'
t � � � ., . . . '
. • / -'
Z - V� '
� '1
� � • �.i
Or� •
Y
N .%1
2
O _
m
N , ,
:.d '-;. N
' �
t: . � �
•� 0
- 9
- N
%� ^d �:j �
� ,� N
,,� _
lw � '
r , �,
_ N
C' �.J `
��
- � .-1 _
�. :' _
' �r�..�'..
, M:�T N � ,.
� ' .�. n C� G t'" �,Y 7 �•
�--," .�F. O �y O ... N C �.. Q
� � . C3'� � .� ry 1n �ID V; 1�N �F -
.. 'O � V1 f �. � .o..`�-:..�u � p y���� �j �� �+'.
. , O n " O= . �., _ a p -
, � o p� ic � �� n � ' O.y w� .. i: i� '.O L �r. `, L'�%
. `-�_. - ': � q ,.� ." C �• ic .hi. �`
� ,,,�V ... .. �._ � ..�Y C.V p " � � C^-. �. v� O � � �
o " �.�.Q��� _ o Y.v_ '^o�= v n �.`^`-' = _ =.� � :^ G
� ^� ^ .:. ^ ^ O �°' _ C ...t- v' �-c-U+� 5. -'. �, ;.�..n :,!•v C,
� " rt' C-r C :'�"� �^.'C : T�. ' . = C G.'C: , .. -C ::�= � ,Rn f: ' ►'
Q �, 4 r. _. �. ��, . p.� ^ �o ".ta v.: .; ��.',^'�� h.. a-F, �a �., .+ . l�
G J -' ;T �".o i c"-^ -��c""^ o-�'� c' p h'c,c �r `r'°^'�.`= ��� m
d P�' i c `^-^ a;.,.-r " �_v c.�; -- �• v,' o: �=�.Q --c.%' � G n r
O v � to 2� o =.' _ �„:_ � � cc..�p � �.� �.�o w'^ �, c .,�" =,�� o='�i: O
� �� � �,. '' � Q,n CS . e�. C r". '` � p �' p � o a �,~,c� n� � F' r, `n' 7 [''1
� � d" _'r�.�`G� ���_ �� �' c - c't,,�,'�" ^•a�.. �c.,o"�^° � �. " ry ^ �
,.�-�� ¢� � -�
• '� � .�.. n ♦ G."� . -~• v� 0 :�C r f4 O h � . �n V ..n , �
, � q^ . ,, c � _ a � c;,c ,� _� -fl '� o r'.�, =c �Y`b o' .. �,
:^� � .r -, 1.��a ^ os'.�.�.c.� ��„ �vF' o oti R =o�% � 3 � `''
� f �' � ^. ..,.�^ '" �V C.. . �;�. .a n � � •-.�A'� -�. • �v�C ' �1
.t �.'< v' �' ^ � a� c � "'_. fl �., :� ^' =-� �c�"_ s?:'w" ..
�, .:�:�„ r o _.�v v :; � .. �.a� r� _�.= <; • p
., . . V V'• t^%.c c �. , •� �-� ::'vu y. c-� c ;, � .a .�u o p j
n =. �^ .^-� a._ v Y •G- r� r� :, X, r p � ;o
• _ - . C r � � h N �.i.^ '-S.. C n G G '' � '.e p 5�.�
� f i�� b CLY� tc�l n^ .' = C C �; � C�.0 n " h� p.:.'w � O n
� - G� N - .^. ...E'+ ^ �..O F ~ r � � � � w U^ '�T' ��O
t-_ ... . �- ' � ,�� -� - - y " pceoo-3c`=�: o -
� . � ``s-, f= C f�' n � G•p'C �'O G � = r �-+� �° '°� v �``^
' . . � . � �� � (: �o = ' c -� �°� � ^' 'i � r''r'
. . . O C o �`. v, n q io C '�_�., r.. j! �.. y:+ „ ,G ly o '- �
% _ e^• •.+ � O ` V p '.'..�"C~ •
� �A � y� r �c�` � a,'` p `, = -II�`_
. ^.q.i ��.- I_�
..'C„' f` ` n �,�O ~ �'i
` � � �,C `�.0 � `~� ' ��i
� �. � � I�i
,..C,_ .
. . . Ll.�� • � I'_���
. I�I�
. � /__
- � '�/�„�.�—
1
�I