HomeMy WebLinkAbout1149A (9) li'UItK6KS CU ll �`tiSiTIGti!lt CL�R 1 fC1N . . � i6Aa64G._._.. . �j p �.
1 herehy aff�nr il:et 1 1is c :i�::tf:cate N on cut tu self CE 818(280 . .; , , ����-��+����� ��,` r��}�l i
mwre,ur a certit'�euzz o��lurkers'Cnmpensunon Insur;�nce,ur HEr+TIN�-VEN�'ILFSTIhiG-i�IR CONDIT�ONING
a canifiad cop+'thcrenf(Sec.3800.Lab.CJ
� Yulicy No.SOZQSO��P2nFREMONT IIIDENlNITY � �
{ � Certisied cnpv�4 here.b}ti�rni+hr COUNTY OF LOS AfiiGEI.ES BU{LDING AND SAFETY
� Czr[ified cop5�is filed with ounty build� � �n+peo ion �BUIL�ING .
dep: t e•t. , FOR APPL�CANT TO FILL IN qooae5
IPRINT OR TYPE ONLY' �---
Da[ AUV���a - ...—� . . . . .
.�urD
NO. ,:TVPE OF Ar'PLIANCE OR EQJ:P 7E'vT PEE � ND B ___ __
CI.2TIk�lC'�1TF OF I-�k.\tlli0'�fRU'�11L'ORI<1:It5' � � .
(,O'IPf.'�SAI ivY 1\S[iH,1Nl-l: � I ��ROSS ST� �J ���s1
(This se�tiun need not he canplmtcd ii [he a'ork involv4l •.aeSoaPTiOn.urv,t.aTu_ ` � —` � O
-- ....._...•.��..�
_.__......._. . ._....:.... _ -.-- � -
by the p�rmit is for one nunJred Jollarc (51�01 ur Icss.) ' i : I s R_r m�. �cE /y� v U
o i� ., �-Ph.. .sG1�l.r.�*i
'AIRHANOLINGUNIT,CFM I I �o
! certiTy tl:at t�Ih: � f. rr�-�ce of the w��rk fur���hich this . _.. .. : .--_.! I O
, �� ; i /D
permi[is:��,se..,!s:�i nc[� �Jo� any pars�n m arn r�annrr I . _.. .... ..--
vn as to hecnme cuF�e�t tn he\5bck.:rs�Cumpu��atiun L1��•s. �BOiLER,BTU . __— -- j . . .__Y I i ,� . V
. -.. �_ i� l�.f'PRO•.:a;S DATE �a,"cr asso-°.cruae
Uatc 4p(��� iC . ' .___ ICOMPRESSOR�BTV_ . ,... -_ �._'__.� .p{ ... . .... �... _-- ...--- N
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' �RC�G �
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. � , ^ I VENTILATiON"YST��.� .. �F.A:AL �a J 6 � 2i� �
Lz�m twn l�iu S �W t��iin -�ube.t to cl�c W>rker." � , . 1 —�—i � - �-- _—
�U1LCE 10�YYLICA�I It aft r m�kin this Ccrtifr te of i a � I
(ompensduor pr rv�v�i.- uf the Lah-�r Code vou mual R(th- ... . ..� �
�roilh cam I H�ith SuJ. y� IEVAPO�ATIVECOO�_Fii � � ��_LIDA?10^!_
F Y pr ro�.�mc ur [hiy rm:t tha❑ �^: � �� e ' �
_.� ._'... __--._.. . � � �
Jeeme;�f^ � �'d. �FUP'VAC_�. FAU—GRAVITVr.' �
LIlF.NSi((tr'p'�i1LACTOR.`.UPCLAR'vTlOti IFLOOR bTu . l
i._
I hcrc6y affirm ti�a:1��m li�rn>.::i.:nacrproei�,itmsc�fChu�+.c' ; '��kEATE!�.�...StJSPE,vUE❑ Util� .' ', ..�
9 (Ccmn�c•.n�mg�ci:h Se:u;,u 7ii0u���,''�?iv+sr-.,; }:,;iii:Husi- 'f i W:.LL ____ I i
ne,s and Yr ifessioes Co,te.a�d��y L.:cnae c-�� fui'r(u r an:t E—� ' ' `
trrr<c. s� �q YJ/�' � 5 3 'j __':�.'��—J�� f'J �v ��lr�tJ�: _
Lm�r„e tiumne�7�/` Lf� e,�.�s,� ....__ +� j ' ' �
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t j i +`
��_� �+�n � J� � �_-,3-� �— � -- - �-----:
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1 am cacmpc �rom th I c��s�ug reywr�mtrt;;i.: 1�m a � i '—�
I�cenSod er�hrte�t �r a re �stered pfot� iunal engineer y P�arl Cfl@Ck fee 2.�.°c Gt a�)Ove, I `
acUn� V� m� pro[e.��onJ avs[i:� (S ciwn 7051, Itus- . . � , . I...-._'�
—___ .
:ne>s und Yrnt,s..,.r...t,�:,,;. � PERhi{7 ISSUf�uG FEE$; ��j Q�
--._
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t.�c.or kr� ��� _---�:::____ �'-- _ I TvTr"ii FEE j.,3.�j✓'!� e �1 1 Q.9 A
HOA7G 011'\f-:i1-HI!lLDFR Aei:i:L:�k.iT10\ �AN CHECK AP^LICAN'f" ' # � 8
.... : • �;� �•
•----_—.._.. ......_ . . ;
1 htreb�� uf(irm thai I am r,xempt trum�the Contractur's �NAS1E 2 C
Liccns� LaW fur tl-ir (ui;ow�ng rcaspn (Section 7C}L5, I}usi- � � wAT.��iT�_QQ�'..._.._. .____� � • ��J�.A J Q
ness nnd Profcssf��>m Ctilej: �Aooaess 21450_GOLDEN_SPRINGS __ - .�. .3 3 5 0�
�--- --- --__.. __ — �p
❑ �. a. . i. vf n.. �rn;,,.i . ! !�: th.�..•-,�.r; ��- u�:c 5 ' '
s(ruuut �s nn1 inT�nded i r uffrrr.d {or tale (b�ction EGT`A]�]f[]x TEL.NO.C�9S-7547 3 �f 1
7044.Businea.�nd 1?rufe,s�unn('oue). 2--�.....— _____ . .. . ..__—.__ �. �G�4�8.1
❑ . ��WNER C� �
f,as u�.ner of the prupertr, am exNusivrly contrarfing . .- .. .. ......................_._.__..—r
-----��._ ..___ pp
with licensad un[ra-tors t- construct the project MAt� 3
(Su�tiUn7043,H���ne�San,i�rnt �.�i�insl'odc). �.ODFF_SS 22127 ���'T� �
CITY TEL.NO. f
c:c�vs7x�ciioti c.i.ti�ivc.,�c;i_ncY � DI�M��tI1-BAI�----_ _ ..... 595--754'�.-. '
I hereby n(finn tlmt thrre i- ❑ cun.[ni,�liun Icnding:+g�+nc}' � �+
for tha performan�e uf the u•url; fot a�hicl� ihis permit ix �CONTRACTOR WALNUT PQOLB__ i
iscued(Sec109'..Cic.C.J. ___. _____--. _.._�
L�nae��.n��„�•__. _ __ �nvoRess 2145U GOLDEN SPRINGS _ . !
Lender's Addretia_ _—_ ---- �CtTV � �7EL.NG - � .
u_._. ra�r.ntuT.. __ _---- ._59s=�sa�---�
1 Cer[if�� that I hase re.�d [his appli�.:[iun ,�nd �ta[c [hut liia �STATE �} LIC.
�huee mform�iUun iti �rretY.1 ug�ae to�umplti ��tt�all Cuun[y � t�I!'ENSE NOJ1g0�.$ CLA5S rj3.�
ordinances � - S�ata laws re�.uln�ing He:rting,Vencila[ing unJ
Air Cun�'" � ing.and! ��l>tnirhorite represen[uti�•es uf[hi� SF:i�.R4:L'7:NSE l��Ok F:%PLAM1ATOI?Y I.A'�Gl!AG1�
'oun o rulcr u� �he abu.�r-mentiuned �?ruF�'r�)' -nr
cnon purposev
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