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HomeMy WebLinkAbout1020A �caaxr.asc�>�.�r�:r.sn�o`nrct.:vt:�no� �eas�ac � ,,�•�..�,> ,«,�m „�,� � ��,�.• :,ccniFirate �,f���«�„< <,>,�,,f CE-F31II(2-BO) A P P L ICAT I O N FO R P E R M IT � in«i�e.o�a crrtificste of R'orkers'Cn.^.ip'nc:rtiun Insu�:incr,or HEATING-V Er�T!LfZTING•AIR CONDITIONING u certified enpl'thereof(�ee.3.400.I.ah.C.) _i. Polic)'Nn. Cnrnpsn}� ! ❑ c�•mnee<<��.•�;i�r.ri•> run,�,n,d. COUNTY OF LOS ANGELES E3UILDING AND SAFETY � ccn�r���a c��p>�t rnrd�.ith thr cnontp Suildin,�insp���c��,� FOR APPLICANT TO FILL IN BUILDING / Jcpartmrnt. . AODRE55 yf1 `��1� L! f�I�� llat�� �\��plic�nt SPRINT OR TVPE ONLY) /�, LOCALITv 8d(� �L , CIiIiTIFIC.\TT OP CXG>II'llOti PRO".f\L'pltKl:RS' NO. TYPE OF APPLIANCE OR EDUIPMENT PEE ��L1��Qn CO`.1Pi:�5:�TIOV I'�SUR:\XC'li NEAREST } (TLis 5ectinn nced no[ he cnmpletrd if lhe �rutk im�olced A9SORPTIO��UNIT,6Tu CROSSST�;�,YyV�, � �� � by Ihc permit ia (nr �me liimdred dnll�rc (51007 or Irss.) ois*aicrr�o. vnoCe55Eoev U I cerlifY'ihet in Ih�• �,��rf��rin;:nce r�f the�•:nrk fnr t�'tii[h Ihis AIR HANDLING UNIT.CFti1 � permit ic isxueJ.I xhall nnt �mrin.a("�. m n}mann.r /�r� Q� /� � 'O ��� O sn as to Lecume su%je<t(o �'. �rn_.tinn I,au's. AOILER,6TU_�!_.] _ � 3 Q r `,� ���I A('PFiOVALS 0�1TE 1NSPECTOP'SSIGN4TUf�E U W natc�`���tl_.3pr��::'��c_ ��� _ ICOM14PRESSOR,�TU ROUGH � ti()Titl:T�):�1'1'LI�:�NT:Ii,;�ftrr ri:ikin;:this L'rrtilic�[e nf VENT�LATION SYSTEM ' FINAL � � z litcmptinn, you +hould Pri�nm„ �uhi�•ct in Ihc lt'orkcrs' a� _ — C'�>m�enssti�in Crocisir�nt�>f Il�t I,;ihnr C'��J:,1"�iU must fnrth- �VAPOf1ATIVE COOLER VALIDATIDN �rith cnmpl)' «�ith surh pnni.innc cr SLic prrmit shall br dr�•rned re�'��krd. FURNl�CE: FAU—GRAVITY I.ICF:tiSCfl COtiTR.1CTf)RS I)i�C1.:IRATIOV F�OOR; 6TU - I lirreh���ffirm:1�^.t I;im li:en�^�i i�n�l:•r i��r�ri�i��ns of CF.��trr HEA7Efi: SUSPENOED UNIT � '7(enmr�encin�;���ilh Sectinn'00!71��f fli.i�i��n 7 nf Il�e Il��ci� WAIL .nrss and Profec�innc CnJr,an;l mc lice•nsr is in full fr�ree snd etfect. 1_icvece Numher I.ie C1�ss Cnntraclor I7:��!. � i am ea�trnpt from Ihe li�•rn.inr rryuircments as 1 am a � Iicensrd archi�ect or a rr��i�trred prufe�sinnal enzinrer Plan eheck fee 2545 Of ebove. aetin_ in my profrxional ea��riq• (Seetinn i051, Ru5- tnrss�nd r�ar�•.,����c��d.�). PERh11T ISSUING FEE S V Lic or�t��.�o.__.._ U:ate � TOTAL FEE ,3 j S!� �� O 2 O.A I10`.(I:O`5'VI'It-[11111.1)!'It I)1�('I.:\li.\TIOti pLAN CHFCK APr'LIC T � ���`�'� �,�$ 1 hereby af(irm �hat 1 dm r�em:'t frnm�t}�,. ['nntr:irtnr'c ^Jq�;G� ���CO r.Jt �.� •3350 Li<enc� l.a��' far Ihc fullmcing rr:i<on (Src[inn '031.5, Pusi- r ��/) 1 nrssandPrn(rstinncCndr)r, t, u ' AODRESS(f/r W! �//�! �,�!I?e iI�!�3350c=i � l. as u nf tl:c Prap.�r�p.��ill d�� dre n�ar1: and thr � � � •�•,��• •^ • ..^• .r. '�• "�, i��r s.^.1^ tirc1iun TEL.NO. nr � �';��a_!hG_n1��,(fi�GL_S°►5='� 1215' 8;1 �70a5.�Au.inr.s and Prnfesslunc('odrr). — OPlNEfi / � i,�c nvrncr of tlir proprrty.:�r.i zcclusi��rty contractinv �� _��/J_.70�"_Y\ ���ith liczn«,1 cnnlr:�cinrc In ri�ntitrucl ih� rrnjccl h1AIL � (Ci•ctir,n 703;,flusinetc anJ 1'r�f<«in9c('�de). ADDRESS q�/_ CITY TEL.NO. cossruoc��ovi.r`in�c:tia�:ncr �i�-/yt� � i��•reny .,irrn, �n,�c �nrre � ��„n«rnri�;��IrnJin;: !rrncY CONTRACTOR fur the perfor�nancc of th� �vork fnr which [his p<rmit is ��a-�� issued(Sec.Jo�'.Civ.C.). I LenArr's lsnie ADDRESS ' I.ender's Addrrs� � CITY TEL.NO. 1 CCffify Ihal I h��'c f"�J thi5�PI`lit:ili��n 2n.1 �t:iie Ihs! 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