Loading...
HomeMy Public PortalAbout8721 GARIBALDI AVE_Mechanical__ '-W9116aWS°°"" "'ffiten'°" °°{°DPYVeJBD APPLICATION FOR PERMIT I hereby arm that I have ■ oerUflcats cate ofoT consent to self Insure, 76I3tf4C or a certificate of Workbr's Compensation Insurance, or a oerfFfled HEATING-VENTILATING-AIR CONDITIONING Dopy therf�oi(8eo.3800 Lab_C.) P,A"No.13��Sf R3 Cornper'y ✓gyp COUNTY OF LOS ANGELES DEPT OF PUBLJC WORKS BUILDING AND SAFETY DIV. ❑ CerMW oopy Y hereby hnTA hod_ copy Is filed with the oowrty bulk9ng Irmpaot ow FOR APPLICANT TO FILL IN (PRM OR TYPE ONLY) Date G-rY '9, App�oarrt l.ocunY No. TYPE OF APPLIANCE OR EQUIPMENT - � . NEAREST CERTIFICATE OF EJmaPTK)N Cfg88 ST. goe COMPENSATKNJ INSURANCE ABSORIT K N UNIT BTU SB ffhts sn n"d not be oofnpfeted tf e work Invotved by the M eatbthe AU,P BOOK PAGE PARCiL parrott Is for one hundrid dollen(=100)or hes.) ATR HANDLING UNIT CFM oferFscr Na MccaNw er I cerfNy that.In the performance of the work for which this permit Is (asued, I shall not employ any person In any manner so as to BO BTU / become subject to the Workers'Compensation laws_ BTU AaPRvv,v.a D+or�:r6Fre ererw7unr Date APpk&m VENTMTION SYSTEM NOTICE TO APPLICANT: If, atter making this Certrflcate of. ROUGH Exemption,you should become subject to the Workers' Componeatlon EVAPORATIVE COOI-ER 6 FWL provtalons 6f the Labor Code, you must forlhwfth oomply with suoh 7 provblons or this permit shall be deemed revoked. FURNACE FAU GRAVITY LICENSED CONTRACTORS IO TN FLOOR BTLI VACONTRACTORSN I hereby Afl1rm that I am licensed ender provisions o1 Chapter 8 8U8PENDED tJNfi (commencing with Sacflgn 7000) of Dlvlalon 3 of the Buslness and HEATEFL W Profseslans Code,aid my Incense Is In full force and effect. r. Lkxww Number Tax-157-T� Lk Claes JL� �✓ �Q ' V contra>lf1p.E, 94s nMhrr6+► Data © Plan check fee I am exampt'Under Bao. CC B.BP.C.Ter this reason PERMIT ISSUING FEE; O H TOTAL FEE a OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT U) I hereby affirm that I am exempt from the Contractor's License Law NAME , for the fallowing reason (8ectfon 7031.¢, Buslnees and Professlons _ 8 V ❑s)i ADDRESS 1, as owner of the property, or my employees wlth wages A•CT.T as their sole.compensatlorl, will do the work and the CM TEL NO. .7703 47.10 'structure Is not Intended or offered for sale (Section 7044, t�C Buelnees and Professions Code). ,l Vyte- �� 1 ITGI k7 ❑ I, as owner of the property, ■m exclusively oontracting AIAtL 1 with 110ensdd contractors to construct the pro)sot (8ec- ADOFtEBS Crites TOTAL A-7 - 10 Jon 7044, Business and Professions Code). CITY 4-f` 'J 9,)-4,/ (, Es No. _ 3 47.10 CONSTRUCTION LENDING AGENCYTC • Ihereby affirm that there Is a construction lending agency for �/. P, , ' 00 the performance of the work for which this permit Is Issued y• j� L - ' (84so.3097,Ctv.C.). ADORE88 nn,�1�VY1 [ i Lenders Name w � t M I 6�14�� CITY , R NO. y�i 1 7 Lenders Address SLATE 'J LIC. LJfXiV 1 AM 1 L:L7' I certify tint I have read this application and state that the above LKAR48E NO. CLASS Information 1s correct. I agree to comply wfth.all County ordlnanow and State lawn relethV to bu5cUng conatructlon,and hereby audVrtre representaVvee of thle County to enter u the above-mentioned property for Ins ton putpoeea. SEE REVERE FOR pXPLAHATORY LANQUAQE " 8 ''SAT'°"°�AsonttJ �°°`a°�° °g APPLICATION FOR PERMIT `IME GREEN, I fierepy etflrm that Y have 4 oertFfloata o1 consent to-soli Insure, �`� or a cerltTloatb of W.orksr s Compsnaatlon Insurance, or a oertFfled HEATING- reOLATING-AIR CONCIrMNING oopythor of Seo.3600 Lab.C.) FlqlCy No. 7-0 O ry COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND 8AFEFY DIV. Certftled copy Is hereby fumhtro . Q Certtfiad'oopy le filed wfth theoo� butldtnp IMPOt ion, FOR APPLICANT TO F1LL IN ADM FZ� (PRINT OR TYPE ONLY) A DaIa�' at't LOCAL" NO. TYPE OF APPLIAQU NCE OR EIPMENT FEE CEFIT(FlC»ATE OF DC EM FROM WOW93S' r T COMPEN4A710y,1 URANCEV / AB8ORFnON UNIT-BTU IOr� . Mls rotbn nand not be completod if the wort Invohrad by the MAP S PAGE W �' parmk t.for one hundred dolttra($190)or". ). kR HANDLING UNFr,CFM t certify^thm st.Jn.the perforance of the work for which this parmh �c�® Is Issyed, I sh4k not emploty. any psrer In any manner to as to gN become subject to the workers' Compensation Laws. ��� BTU �rOgtat DATE- 06510croorrsprvrurw r Doe ApPicarrt' VENTILATION SYPTEi1 NOTICE Ta APPLICANT'. I1, after making thla`.CartlLlcate of ROUGH Ex6mption,you koukf t»oome subject to the workers'Compinaatfon EVAPORATIVE COOLLR •proNelons of the labor Code, yci r must lbrthwfth oompty,wfth such Fw,L provisions or thlf parmh shall pe'deemad revoked. RAINACE FAU GRAVrrY' UCENSED.9ONTRACTOR9 DECLAF1ATK?4; FLOOR BTU LIDATION I,hereby affl�m that I am licensed under prgv141bns of Chapter 9 FIEA8UBPENDED -U r (commenolny whh'8e on 7000) of Divlslon 3 df the Builneas and er rf wAL ?' } Professions Code,and my Ito ense to In,full force'¢nd affect. 4 -7— License Number 0 Lk>_Claes /� -` } 7'` 74.ii 1 tDate Plan check fee TO -74 o� 1 I arty.exempt Older Seo Q B.BP.C.for this'reepor� PERMIT ISSUING FEE i C�ECK �4.��Date: TOTAL FES u fA ER=BU[DER DECLARATK>N '. PLAN CIECICAPPLICMfr j —1F�t__Fi 25/92 z I hereby'&Mrm that.] }fir exempt from'the.ContrWor'a Lomas Law NAME d f0[ihe followlno-reason (Section 7031.6,Bpalnaas.and Profeesl6ns Code): ADDRESS DI, as owner of the property., or my employees with wage4 as their sole 6ompensatlen, *IH do,the'work and the CITY TEL.40. �rt�n' -' 1 structure Is not Intended or offered forams (Ssotlgn 70A4, rr--tl�1J'��ffA Buelnesa and Profeaalom Code). OWNER , lllCtfi Et. 1 I, so owner of-4fie,property, am exclusively oontracting MAIL with licensed o'ontrOactors to construct the project. (Seo- ADDgE66 tion 7044, Buolneea and,Profaasions Cods). CITY T�NO. CONSTRUCTIK3N LENDING AGENCY I hereby affirm that there Is a oenstruotlon lendingagency for " frrrrr { �/ { the peRbrrilatic0 o1 the work for whtoh thle.perlt Is Ins ad T� , - L■- �} `/4, �r 3097,Civ. C.). 2b3 1915 1 Al�l 1'3S :. ADDFrEs6- Londerrs Name -- ary. TEL NO. LorKWe Address ' I cprtffy that I have read this application and state that the above LICt 8E NO � LIC. — tr 6mudion Is correct I agree to com.pty with all County or'dlnences and State lawn relating to twlidIN conaUuodon,and hereby audw tze of this Courtty to enter upon the above-mentioned rfy to SEE REVERSE FOR EXPLANATORY LANGUAGE Tuts ori Aa2NT DAM