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HomeMy Public PortalAbout5936 ENCINITA AVE_Mechanical__ CE-818.IREV.6/781 - - ©, , " APPLICATION .FOR PERMIT HEATING - YENTILATINGa AIR CONDITIONING COUNTY OF LOS ANGELES .� BUILDING.AND SAFETY FOR.APPLICANT TO FILL IN BUILDINGADDRESS. - ••{`1 (PRINT OR TYPE ONLY). " LO - CALITY NO TYPE OF APPLIANCE OR'EOUIPME �NT - -'FEE' -I ^ -1. NEAREST, .. • CROS5 5T:, - ABSORPTION UNIT BTU 1 OWNER :.y. eI -.. . .. AIR HAND-LING_LIN IT,CF.M � - � :' MAIL1 ' ADDRESS A BOILER.BTU ' CITY TEL.NO. COMPRESSOR BTU �y' 'in Y r -s - _ /./Y CONTRACTOR � VENTILATION SYSTEM r . ADDRESS ' . U11 r •. _ APORATIVECOOLER 1- CATV TEL NO. " FURNACE :; .FA ULo"GRAVITY. (y A STATE v LIC. f FLOOR BTU "/f/.1 LICENSE NO. • CLASS HEATER. ••SUSPENDED_UNIT .+ - .�!} WALL 1 APPROVALS' ' DATE: - INSPECTOR'S SIGNATURE tl . RO)JGH :O. Y FINAL'. ;•t INSPECTION'.RECORD. J I W Plch-check fee 25% of above.' + - - PERMIT,ISSUING FEC$ 1 'TOTAL FEE . W' PLAN'C HE�KAPPLICANT - I T. I PLAN CHECK VALIDATION , NAME'. - i - ,I �' .r t . ADDRESS = n C ITV _ / ,, :\,. TEL NOa-/ ' ♦ ^T lY � t a q 1 I'HEREBY ACKNOWLEDGE THAT HAVE RAD;TNIS'APP[ICATIONrANO -ORDINANCES:ANDS. D O COMPLY INTH T S.REGULATING H ATING. VENTILATING, AR �T�af b ,' f'}: corvmrlorvwI jr` - - PERMIT VALIDATION - IIHEpEBY CTIFY.�THAT .I AM' NOT ACTING.IN VIOLATION OF CHAPTER 9. DIVISIOW�, OF THE BUSINESS AND PROFESSIONAL CODE OF THE STATE OF CALIFORNIA .,._.._.,,, Y SIGNATURE .OFPERMITTEE. J/../✓T. .'tel'. / �/ YI ., DISTRICT ND. PROCESSED BY 1. ` 1 I _ - ft _ . . 76.X366C 'nE�8y INEV'6/781 r5, APPLICATION FOR PERMIT HEATING - VENTILATING '- .AIR CONDITIONING COUNTY OF LOS ANGELES BUILDING AND SAFETY UILDING FOR APPLICANT TO FILL IN Bj� (PRINT OR TYPE ONLY) ADDRESS {- 41v-e- (PRINT £. f •NO. TYPE OF APPLIANCE OR EQUIPM ENT FEE - NEAREST � ) /� 'ROSS ST. (/V O T ABSORPTION UNIT,BTU - OWNER/,,, .^. F J' C✓�Fi AIR HANDLING UNIT.CFM MAIL • ADDRESS J Ar- F-fJ4 lS.LZ BOILER,'BTU CITY C� TEL.NO. 9 / COMPRESSOR. BTU + too r-C CONTRACTOR VENTILATION SYSTEM ADDRESS EVAPORATIVE COOLER CITY - TELNO. FURNACE: , FAU��GRAVITYi Q O STATE LIC. FLOOR BTU A2� ear 1 LICENSE NO. CLASS HEATER: SUSPENDED UNIT__ APPROVALS- PATE INSPECTORs SIGNATURE WALL - ROUGH ' •�� � ,�� FINAL 6 ..'INSPECTION RECORD V --- - \: o Plan check fee 25% of above. w IL PERMIT ISSUING FEE; B Y TOTAL FEE- p � / - PLAN CHECK APPLICANT PLAN CHECK VALIDATION - NAME ADDREss �97 6 Q 3 A ' CITY - ` TEL NO. # 0,0'0 6 (4 1 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND _ STATE THAT THE ABOVE 15 CORRECT ANO AGREE TO COMPLY WITH ALL / 2 e - 2.7.00 ORDINANCES AND LAWS REGULATING HEATING. VENTILATING, AIR - CONDITIONING. PERMIT VALIDATION a • a 27,0010 I HEREBY CERTIFY THAT I AM NOT ACTING-IN-VIOLATION OF ' - CHAPTER 9, DIV15ION 3. OF THE BUSINESS AND PROFESSIONAL-CODE. _ I I O _7 n' OF THE STATE OF CALIF�PNIA. - 1 1 ' SIGNATURE / OFPERMITTE DISTRICT NO. PROCESSEOI `C��.. s, o� • ' r. WORKERS'COMPENSATION DECLARATION 76A364C L IC F"i 1 I O 1 tl I.O Y'i PERMIT 1 hereby affirm that 1 have a' certificate of consent to self CE -818(2-80) insure, or a.certificate of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING a tifi.l copy th`rJe�rf,((Sec.3800,Lan.CA '6TGx�7-v_W impany— ❑ Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY CCeePrtified ccoopyy is filed with the ...nty bui inspection FOR APPLICANT TO FILL IN BUILDING //^ Da0.d=ar�p_Y Applicant (PRINT OR TYPE ONLY) ADDRESS) CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALIT>�l1�� COMPENSATION INSURANCE NEAREST / /�C✓� a (This section need not be completed if the work involved ABSORPTION UNIT, BTU CROSS ST. /�"/ri by the permit is for One hundred dollars (SIBB) Or less.) DISTRICT NO. PROCESSED aY 0 I certify that in the performance of the work'for which this AIR HANDLING ON IT,CFM Q permit is issued, I shall not employ any person in any manner / eo so as to become Subject to the Workers' Compensation Laws. //' BOILER, BTU_ Y...S_ _O.0D -, 1 I- / I APPROVALS DATE INSPECTOR'S SIGNATURE L) Dale Applicant COMPRESSOR,BTU ROUGH Z CL III NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL >� Z 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 permiC'shall be deemed revoked. FURNACE: FAU_ GRAVITY— LICENSED CONTRACTORS DECLARATIONFLOOR: BTU — I hereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT 9 (commencing with Section 7000) of Division 3 of the Busi- WALL ness and Professions Code, and my license is in full force and ' effect. QQ�� License Numberv���/_ Lia Class G J v_ ✓ Contraclo ��-Date ❑ I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer Plan check fee 25%of above. acting in my professional capacity (Section 7051, Bus- ,...pp iness and Professions Code): PERMIT ISSUING FEE $ 7/ Lie.or Reg.No. Date TOTAL FEE. HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby .affirm that 1 am exempt from- the Contractor's [ADDRESS �� , License Law for the following reason (Section 7031.5, Busi .93917A ness and Professions Code): ❑ 1, as owner of the property, will do the work and the t ' Ii•;e rs e s $ structure is not intended or offered for sale (Section ��i1 A�� TEL. NO lS i1-� t , 7044, Business and Professions Code). r-��/ b 2�•�• 3 7J.5 0 / Q� ❑ I, as owner of the property, am exclusively 'contracting ��� ' with licensed contractors to construct the project p afe;e 3 Tj,5 (Section 7044, Business and Professions Code). s;�i' "�j • ,. CONSTRUCTION LENDING AGENCY CITY TEL.NG�J G� r/�/� ,O.f1 0 V-$2 I hereby affirm that there is a construction lending agency AGO jar for the performance of the work for which this permit is CONTRACTOR_ O /�— issued tSec.3097,Civ.C.). - f--r- Lenders Name ADDRESS Lender's Address CIT" / / A� e TEL. NOS//({•JJ/��//� 3 1 certify that 1 have read this application and state that the S ATE �JC//' LIC. Y/v T -r above into•.ration s correct. I agree to comply with all County LICENSE NO. J'/_rJ L CLASS L, �1 � ordinances and Sta,e laws regulating Heating. Ventilating and Air Condit- _'_g, ,nd hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE .aunty r e •(r upon the above-mentioned r' 'per y for Signatw :of PeuniVro ���� Y to