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Home My Public Portal About9024 CALLITA ST_Mechanical__ '°A364EI E'B,BA)-°nT APPLICATION FOR PERMIT HEATIN VENTILATING - AIR// CONDITIONING �• `�jJ), NTY OF LOS�LES DEPA T�OFCOUNTY ENGINEER. BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN BUILDING ee (PRINT OR TYPE ONLY) ADDRESS • LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE - NEAREST CROSS ST. ABSORPTION UNIT.BTU OWNER fJ AIR HANDLING UNIT.CFM MAIL ADDRESS //�� BOILER,BTU CITY TEL.N07(2/ COMPRESSOR.BTU CONTRACTOR CI[�� `)u VENTILATION SYSTEM ADDRESS v EVAPORATIVE COOLER CITY 6 V✓I TEL.NO.Z85-z2G/- m FURNACE: FAU=GRAVITY - STATE. yT•�. - LIC.. FLOOR BTU LICENSE NCLASS - - HEATER: SUSPENDED—UNIT— DISTRICT NOI ^IONS PADCESSED B7 WALL DBJ��NUP r\ `� E INSPECTION RECORD �' O • u m O Plan check fee 25% of above. PERMIT ISSUING FEE$ z TOTAL FEE Z PLAN CHECK APPLICANT NAME ADDRESS TTJ,n vm CITY, TEL.NO.2(3J-2,Aq HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH.ALL ORDINANCES AND LAWS REGULATING HEATING. VENTILATING, AIR CONDITIONING. I HEREBY CERTIFY THAT IAM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE CHAPTER 9, DIVISION 3. OF TME BUSINESS AND PROFESSIONAL CODE ^•�� OF THE STATE OF IF INIA. ROUGH .? SIGNATURE FINAL a/ OF PERMITTE PLAN CH K VALIDATION cK, M.o. cnsH PERMIT VALIDATIO cK. w..o. CASH .�� 60 5�MRY 24 4 1 D 2 x.17 0 o. WOR KLRS�COMPENSATION DECLARATION CE 81 C APPLICATION Ip I� p T N PERMIT y I her,Iby pffi m that I have ;y certificate of consent to self CE-818 (2.80) P'Y r Ir L IC P9 1 I O 1 tl I.O If� I=fi IVI I 1 insure, or a certificate of Workers'Compensation Insurance,of HEATING•V ENT ILATING-AIR CONDITIONING a certifiedcoppv thereof(Sec.3800 - bb CCy�) Policy-No&7.im pan - Certified copy is hereby furnished. COUNTY OF LOS ANGELES - BUILDING AND SAFETY Certified copy is filed with the county buil inspection - FOR APPLICANT TO FILL � BUILDING r f drpar�t m�7ent t� /fit .. ADDRESS /�!r/I (Z(/ Date_I-I-..)( _� tpphcant_IX— (PRINT OR TYPE ONLY) � - LOCALIT e CERTIFICATE OF EXEMPTION FROM}WORKERS' FABSORPTION TYPE OF APPLIANCE OR EQUIPMENT FEE - COMPENSATION INSURANCE' - - NEAREST - T (This section need not"be' completed if the work involved UNIT, BTU' CROSS ST. _ O by the permit is for one hundred dollars (SI00) or less.) DISTRICTNO. - PROCESSED ByI certify that in the performance of the work forwhich thisANDLING UNIT,CFM l-/ � cc ccpermit is issued, I shall not employ any person in any manner - Cbso as to become subject to the Workers' Compensation Laws. R,BTU - f' - 1 APPROVALS DATE INBPECTOR's SIGNATURE LUU Date Applicant COMPRESSOR, BTU [_O -� ROUGHN NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEMFINAL tJ '.2'- Z Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth-, EVAPORATIVE COOLER VALIDATION. ' with comply with such' provisions or this permit shall be -deemed revoked. FURNACE: EAU_ nR /IT�"y�j LICENSED CONTRACTORS DECLARATION L FLOOR: r N—��J QV{/— JO t hereby-affirm that-tram-licensed undenprozisions ofChapter -- _-- HEATER;--SUSPENDED ---UNIT -- - •-- ---_ _ -.`- - -- — --_- -- 9 (commencing with Section 7000)of Division 3 of the Busi. WALL - ness and Professions Code, and my license is in fullforce and effect. License Number G_e7 � �!/ Lia Class—p> ContractorR-�,_/ Date I am exempt from the licensing requirements as 1 am a - licensed architect or a registered professional engineer ,Plan Check fee 25%of above. - acting in my professional capacity (Section 7051, Bus- iness and Professions Code). PERMIT ISSUING FEE $ I 5 2,7231 A Lic.or Reg.No. Date TOTAL FEE 30 (`l i HOME OWNER-BUILDER.DECLARATION PLAN CHECK APPLICANT t 13 QJ O o s 1 'hereby affirm that I am exempt from-the. Contractor's License -Law for the following reason (Section 7031.8. Busi- o e e Tj Q 0 t. ness and Professions Code): ADDRESS I, is owner of the property, will do the work and the %•I•)'3 W 83 structure is not intended or offered for sale,(Section CITY TEL. NO. 7044,'Business and Professions Code). OWNER L as owner of the property.-am exclusively contracting ( with licensed contractors to construct the project MAIL �O Section 7044, Business and Professions Code). ADDRES - CONSTRUCTION LENDING AGENCY C1T �iti' -E L. NO. I 'hereby affirm that there is a construction lending agency for the performance of the work for'wlfich this permit is CONTRACTOR _ issued (Sec. 3097,Civ.C.). Lender's Name ADDRESS Lender's Address _ CITY �/rt,,,, �IrKK�- TEL.L.. 4310 .. . . _ .. 1 certify that I have read this application and state that the STATCCCEIJI"""WWWppp"'VVV✓Jrrr rr, y LIC. above information is correct.I agree to comply with all County LICENSE NO. -�•� /� CLASS ordinances and State laws regulating Heating. Ventilating and - - Air Conditioning;and'hereby authorize representatives of this .SEE REVERSE FOR EXPLANATORY LANGUAGE , County to enter upon the above-mentioned property for .. inspee m purposrt. - -i� - Jrgnalureofr .nittee Dalt: I 1 WORKERS'COMPENSATION DECLARATION APPLICATION ��n �� A��®�O r�®� ®��pp�� ' I hereby affirm that I have a certificate of consent for self � +� /'9 IL P9 Y\7 (�' PERMIT . insure, ar a certificate of Workers' Compensation Insurance, HEATING' - VENTILATING - AIR CONDITIONING ' or a certified copy thereof (Sec 3800, L C. CE 818 f // -CE-818(REV. 10/81) P❑ohcy No.(Q 0_92ompany - 1. by Certfied'copy is herefurnished. COUNTY OF LOS ANGELES BUILDING.AND SAFETY Certified copy is Filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING ti/o�nn deep-art(mmenntt (PRINT OR TYPE ONLY) ADDRESS Date 1LLL{_T,LyL Applicant LOCALITY NO. TYPE O_F APPLIANCE OR EQUIPMENT' . FEE CERTIFICATE OF EXEMPTIONFROM WORKERS' - NEAREST - -- CROSS ST, COMPENSATION INSURANCE - (This section need not be completed if the work involved by ABSORPTION.UNIT, BTU - DISTRICT NO. PROCESSED BY the permit is for one hundred dollars ($100)or less.) CFM,AIR HANDLING UNIT .- ' I certify that in.the'performance"of the work for which this .._ c rid q permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws. BOILER, BTU APPROVALS DATE INSPECTOR'S SIGNATURE' Date Applicant COMPRESSOR, BTU ROUGHS NOTICE.TO APPLICANT: .If, after making this Certificate of VENTILATION SYSTEM FINAL -2- ��- Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code,'you must forth- EVAPORATIVE COOLER- VALIDATION with comply with such provisions or this permit shall be - deemed revoked. FURNACE FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR Thereby affirm that'l amlicensedunder pfovi sions'of Chapter 9- -' -- -SUSPENDED- '(commencing with Secfion.7000) of Division 3 of-the Business HEATER: WALL- and Professions.Code, and my license is in full force and effect. - r License Number 2493412 Lic. ClassJ.� V V R o Contractor Date - ❑ I am exempt under Sec. ,_ - d Plan check fee o2 3 j O B.BP.C. for this reason _ - y "— PERMIT ISSUING FEES Z Date: Signature - _ _ - TOTAL FEE O C) _ - OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License - Low far the following reason (Section 7031.5, Business and NAME D - - 2 6 0.3.4 A ' Professions Code): � - ❑ I, as owner of the property, or my employees with ADDRESS t o e a o •,g wages as their sole compensation,will do the work arid 2•• • S 4 the structure is not intended or offered for sale(Section CITY TEL. NO. i 0.0 7044, Business and Professions Code). - OWNER-- /e.e • �j(( Q Q El. I, as'owner of the property, am exdusivelyconiracling 0 with licensed contractors to,construct the project (Sec- MAIL Ulan 7044, Business andProfessionsCode). ADDRESS CONSTRUCTION LENDING AGENCY CITY 'TEL NO. I hereby affirm that there is a construction lending agency forra& D the performance of the work for which this permit is issued CONTRACTOR (Sec. 3097, Civ. C.), - , ADDRESS Lender's hame ' CITY TEL. NO. Lender's Address STATL - LIC. t certify that I hove read this application and state that the LICENSE NO: - CLASS -•-- .. ..- .. - _ above information is correct. I agree to comply with all County ordinances and State laws relating to building construction, and her y.out horize representatives of this County to enter uPon th above-mention roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE .. .. J'/J ,-17-P3 Signature of Ap is tit or Agent Date