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Home My Public Portal About9549 GARIBALDI AVE_Mechanical__ WORKERS'C°h'�"°"°cons APPLICATION FOR PERMIT I hereby affirm that I have a urif#icate of consent to self I Insure, or a certificate of Work Co Ion Insurance, HEATING - VENTILATING - AIR CONDMONING or I � � 9/BE-: Policy`INo ny Certified 4ogy is hereby furnWh6d COUNTY OF LOS ANGELES BUILD AND SAFETY Certified copy N filed w1th co my build]r>fl 1 FOR APPLICANTurti TO FILL IN BND- .i t r (PRINT OR TYPE ONLY) ADDRESS / pet. o=t LOCALITY Wd � NO. TYPE OF APPLIANCE OR EC MMENi FEE F $i CERTIFICATE 4F EXEWipT10N WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST- .Pis sedim iwed net be IW the work Irrrolved by AmowTxJN UNIT, BTU^ DtSrRICT No.me "}-- peratlf Is For 0"hu Bassa($100 c r Ian.) AIR HANDLING UNIT, VM' - - ,� i-Ify that"In the perfarrr.T e.of AV' work for,which this dA owmit is lssijgd, I W-0winat employ arty Person In any marine{ 8711 IA so as to become sub{ed to the Woriws Copensatlbn Laws APPKNALS DAn i SCN'n WE Iyate4,,nj{�t' I C3MPRE SOR MROUG�I jVdTiCE.TO APPLICANT': if, after making thl} Certificate of VENT4.AT10N SYSTW FINK EtcempHort, ydu dtquld become, subject b the Workers of ' I Cpmpensution provlsfoAs of the Labor'Code, you must fortis EVAPORATNE CooLER. ATl N with comply with such provfsiorts or this permit shall be do*m- ti .Sid revoked. RJRNAM FAU v �. LICENSEDCONTRACTORS DECLARATION FLOOR BN --'I hereby affirm that I am Ikerned under provisions of Chapter 9 HEATER_ SUSPENDED) UNIT (eommencing with Section 7000)of Dlvislon 3 of the Business WALL and Profentons Code,and my license is in full forcl and effect. r uCL License Numb, t�c Class 0 Contrtactor Ix U ` E c I am eximpt under Se - O Plan heck fee W B d?.0 for this reason : PERMIT ISSUING FEE $ Z .cite100 -TQTAL FEE Signature OWN:ER43UfLDER DECLARATION PLAN APPLICANT - _ _ I hereby affirm that I am ex*rLpt from the Contractors License Law for the followihi; reason (Sedion 7031.5, BusInefs and !NAME Profea�ons Code} n1, as owner of the property, or my employees with ADDRESS- wages as their sole compensation,will do tl,r work and ACM4 the structure is not Irdended or offered for sale(Section CITY TEL NO. a 7 ., Bush ,,er and Prof. kwa Code; 3307 103.00 04 I, as owner of the property, am exclusively contracting .___ 1 ITEMS' with Ilcen;ed contractors to construct the project (sec- MAIL ' r tion 7044, &Wrw n and Professions Code} ADDRESS_ TOTAL 103.OC. --., CONSTRUC'hON LENDING AGB Y aTY i TEL. No. I hereby affirm that there is a conxhvctton lending agency for - {wci 103.00 the performance of the work for which this permit Is Issued CONT Ac .00 (Sec 3097, civ. C. ADDRESS Lenders Nam. aTY TEL NO. 000IG-W 5/263/90 Lenders Addr— STATE Ur- 0859 1 Ali 7:10 I certify that I have read this application and atop that the LICENSE NO. CLAM above Information is carred.I agreeto comply with aliCounty nus and State laws relating to building construction, and by authorize vas of this County to enter n abov enti for I Purposes SfBz REVQSE FOR iJ(PLAHATQRY LANGUAGE q rxxhj of AacJ cwnt or A.-,ent Date 4ORKURS'&)',IPENSkTIO`1DECLARATION ,; 78A36.8(�-Bo, APPLICATION FOR PERMIT I fleshy affirm. th5t I .have a' tiertiflcate of consent to self ,t insure,br'scertincataofWorkers'CompensatlonInsurance,or HEATING-VENTILATING-AIR CONDITIONING certlald r-c there Q- — c. 00. Leh. r.) Polic3 No! ^" pany COUNTY OF LOS ANGELES BUILDI Certified cnAy Is hereby furnished. AND SAFETY dert�ed copy is flledwithtthe county b, ding Inspection FOR APPLICANT TO FILL IN BUILDING Date -fApplicant (PRINT OR TYPE ONLY) ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS'_ NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY 0 COMPENSATION INSURANCE NEAREST } Mis section need not be completed If the work involvedABSORPTION UNIT, BTU CROSS ST. tl by5 the permit .is for,pne hundred dotlara. ($100) gr less.) DISTRICT NO PROC asED By 8 .t I certify 4hat in the performance of the work for which this AIR HANDLING UNIT,CFM permit is Issued, I shall not employ any parson In any manner . 0 to as to become subject to the Workers' Compensation LAws. BOILER, BTU RFJ APPROVALS DATE Ina TOS SIGMA RC Date Applicant COMPRESSOR, U _ a. ROUGH UJ NOTICE TO APPLICANT: If, after malting this Certificate of VENTILATION SYSTEM Exemption, you should become subject to the Workers' 1. FINAL /7,0 ,Compensatlon provisions of the Labor Code, you must forth- EVAPORATIVE COOLER with comply with such provlslons or this permit shall be VALI 0 deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLAR.AMON FLOOR BTU I hereby affirm that I am licensed under pr, -)vof Chapter HEATER: SUSPENDED UNIT 9 (commencing vAth�c * 1000) of D. Iston 3 of the Busi- WALL nest and es3lon's Code. and m. -ense It in full force and effect. , r I y Lf Number (Tye Lic. CI CJ Con cte ate QI re from the licensirequirements as 1 am a licarued stered professional engineer Plan check fee 25%of above, acting In my pro I capacity (Section '7051, BW- iness and Profe-Wons Code). PERMIT ISSUING FEE $ Q Q Llc.cv Reg. No. Date TOTAL FEE H014E OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby arFlrm that I am ex-mpt from- the Contractor's NAME License Lex for the following reason (Section 7031-5, Busi- ness and Profmsiorts Code): ADDRESS ACCT.4 1, as owner of the property, µ•i11 do the work and the ACC .4 structura is not Intended or offered for sale (Section CITY TEL. NO. 7044, Business and Professlorts Code). 0-0.50 CWNER I, as owneI r of the property, am exclusively contracting 1 TS with licensed contractors to construct the project 1 (Section 7044, Business and Professions Code). Try�As ADDRESS TOTAL 11L CONSTRUCTION LENDING AGENCY CITY TEL.NO. GECK 188.54 I heraby affirm that there Ls a cunstruction lending agency ry� for the performance of the work for which this permit Is CONTRACTOR .00 Issued (,Sec. 3097,Clv.C.). LandarsName :,DDRESS �y-yy�_�yy�i �7/+7�/pp -Lender's address CITY TEL.NO. lJtMr-�.MJt /!�//2�(1f 07 1 certify that I have read this application and sate that the S i ATE LIC. 47M 1 17110:52 above information is correct. I a�Tee to comply%%ith all County 1�_ICENJSE NO. CLASS -urdinan�cs and State Ian's regulating Heuting. \rntilating and Air Cundirioning. Lind h,:rrby authorise represent.ni,.ea .�f this SEE REVERSE FOR. EXPLANATORY LANGUAGE Count) to enter nron the shove-mentioned property for inspects n r• CU�oI 7'oq WORKERS' COMPENSATION DEC1APAnONAPPLICATION FOR Pf RMIT I herpby-aMrp that I have a certificate of consent to self Insure, or a certlfkxte of Workers' Co otion Insurance, HEATING - VENTILATING - AIR CONDITIONING or- 14 )Pw 9/w.l Pol}cyc� Company r�'� ECertified copy It hereby furnished COUNTY OF LOS ANGELES BUILD AND SAFETY Certtfted copy is filed wi 4cot-y uliding Ir- FOR APPLICANT TO FILL IN AA>�. — _A (PRINT OR TYPE CLAY)pate [cant PIO. TYPE OF APPLIANCE OR EQUIPMBlT L(KA1fTYCH�Tl�ICATE OP Q(EAAPTIRKERS' NEAREST V ' COMPENSATK)N INSURANCE ABSORPTION UNR, BTU C720dS sr. Mis s*cftom weed n*bp torr rtplef IF the w-*W-red by �KT.r_'+s' n the peimlf b for see Iwnd ed ($W or less.) _ AIR HANDLING UNfT, CFM I certify tf� In the performance of tl,* work for.which this A' y pwmh is Issued, I shah not employ any person In any manner so as to become subject to e Wo*&W C.ompematlon Laws. EIlJ thAP*VAIS DAi Sr_ Tuw I COMPRESSOR,pnrw ROUGH ayolcont - BTU NOTFCE TO APPLICANT: If, after making this Certificate. of VENTILATION SYSTEM FINAL Exemption, you' should become s4bject to the Workers' Compensation provieQns of the,Labor Code, you must forth- EVAPORATIVE C)OOLEif_ V N wI_th comply with such prbyfsions or this permit shall be demi- } ed rw FURNACE FAU VI UCENSM CONTRACTORS DECI.ARATK)K- R-OOR BTU 72,%1290 11 hereby affirm tfxrt I am licensed under provislons.of Chapter 9 ITER: SUSPENDED UNIT (commencing wfth Seciton 7000)of Division 3 of the Business W ALL t and Profession Code,and my license Is M full andeffect. _ k License Numh. I Ic Mass - - a 0 Contractor . 4 ❑ I Win.exempt under Sec. O . Plan heck fee' G lir B sp.0 for this reason PERIWT ISSUING FEE $ Date: Z TOTAL FEE OWNIR43UIIDER DECLARATION PLAN d�EC]c APPLICANT - I hereby afffrm thgI I am exempt from the Contractor's License , Ww for the following rwsgn (Section 7031.3, Bufiness'and NAME f Prafeesions Code 1 ❑ . I, as owner of the property, or my employees with ADDRESS—. y wages as their sole compensation,will do the work and � TEL NO. • ACCTAr 0 - the structure is not Intended or offered for sale(Section 1 . 7044, Business and Professions Code} 00 ❑ I, as owner of the property, am exclusively contracting — 1 ITEMS with licensed conki3dars to constrict the project (Sec- tio„7044, Business and Professions Code) TOTAL 103. 00 CONSTRUCTION LENDING', CITY ` TEL NO. I hereby affirm that there w a construction lending agency for C�ECK 103.1.14 the pwform<=e of the work for which this permit is *wed CONTRACTOR .00(Sec 3097, Clv. C) A Lenders Name yy�_�yy wry CITY TEL NO. 13000—OWI 5/2x/70 Lender's Address STATE I certify that I have read this application and state that the acaSE'NO. �CLASS 409 1 All 7:10 above Infbrmatlon is corned. I agree to comply with all County and State laws relating to bul ing construcllon, and. authorize r ves of this County to enter n abo entlo for In purposes. SM REVERS FOR EXPLANATORY LANGUAGE nrrtn of A�wJLcont, Aon Dat. h WORKERS'( 0',IPENSNTIONDECLARATIONI, CE -S (2-90) APPLICATION FOR PERMIT I heraFry' &Timm`rhnt I 'av• a �ertiftcvt of content to self t Insure,,br'r certlficate of W'orkers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING n certlfled r v therm` �. 600, Lab C.) Polfcy Nopy COUNTY OF LOS ANGELES ❑ Certifled copy is hereby furnished. BUILDIN AND SAFETY ❑ Certified copy Is filed with the county h ding inspection d art . FOR APPLICANT TO FILL IN BUILDING Date Applicant (PRINT OR TYPE ONLY) ADDRESS Avg CERTIFICATE OF EXEMPTION FitOb1 1VORK�RS' PJ O. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY 0 COMPENSATION INSURANCE NEAREST (thin section need not be comppfeted If the Rork Invoh-ad ABSORPTION UNIT, BTU CROSS ST. tl by the permit is for 9m hundred,dollars (5,100) gr less) DISTRICTNo rrroc wEo Y (� ' I certify that In the performance of the work for which this AIR HANDLING UNIT CFM permit is issued. I shall not employ any person In any manner so as to become subject to the Workers'Compensation Lases. BOILER, BTU O APPROVALSDATE NSA TOWSSIGNA RE U W Date Applicant COMPRESSOR U ROUGH — NOTICE TO APPLICANT: If, afrar making this Cartlflcate of VENTILATION SYSTEM Exemption, you should become subject to the Workers' FINAL • Compensation provisions of the Ltlbor Code, you must forth- EVAPORATIVE COOLER ,s-Ith comply with such provisions or this permit shall be VALI FlWtOA deemed revoked- FURNACE: FAU GRAVITY— LICENSED CONTRACTORS RAVITYLICENSEDCONTRACTORS DECLARATION FLOOR BTU I hereby nfflrm that'I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT 9 ( GtIng w-it��t ' 000) of Division 3 of the Bust- WALL nese5ons Code, and ense Is in full force and effe Licer 0G6Lic. CI G�y 14 Con - 17 N613.t• e 1 1 ❑ from the licenii requirements as I am a c tered professional engineer Plan check fee 25%ofabove. my pro I capacity (Section 7051• Bus- Iness and Pr6fnaJoru Code). PERMIT ISSUING FEES Q Lie.or Reg. No. Dare TOTAL FEE HOSIE OWNER-BUILDER DECLARATION Ply CHECK APPLICANT I hereby affirm that I am exempt from- the Contractor's 1,I4ME License Law for the fo4owmg reason (Section 7031.5. Busi- ness and Professions Code): ADDRESS s - ❑ 1, as owner of the property, sill do the work and the a ACCT i* structure is not intended or offered for sale (Section CITY TEL. NO. 8$-50 7044, Business and Professions Code). I1 ❑ I, as owner of the property, am exclusively contracting OWN ER I ITEM 1 wlrh licensed contractors to construct the project MAIL I (Sectbn 7044, Business and Professions Code), ADDRESS TOTAL 188.5 CONSTRUCTION LENDING AGENCY CITY TEL. NO. 41• CK 188.5 I hereby aftlrm that there is a constructiun lending agency for the performance of the work for which this permit is CONTRACTOR t# .0 Issued (Sec. 3097,Cly.C.). Le n d u Name ADDRESS �y�yy��yy� 7 +'J'7/per • Lender's Address CITY TEL. NO. - tJtJ100—LI�RII ,l7�27 87S 1 certify that I hate read this applicatWn and +tate that the STATE LIC. 4707 I (7110=5'1 above Information is correct.I scree to imply %%ith all Count> 1_Ir•EN E NO. CLASS ordinances and State laws regulating !ieatinr. Ventilating ;ind Air ConJitloning. and hcrchy awhori_e representati%es of this jEE REVERSE FOR EXPLANATORY LANUUAGE County to enter upon the ,b.,ce-ment!,lned property for - utspectlon "f°`� COMPENSATIONIhav DECLARATION APPLICATION FOR PERMIT I hereby affirm that I have a certffkate of consent ro self I„a,ne or acerffficase of Workers' ^earl«, Insurance, HEATING - VENTILATING - AIR COND�TIONINf3 or a c fi �°"��,�„ opus 9/16 . l�l1`y `byfum COUNTY OF LOS ANGELES BUILD AND SAFETY • ❑ Certified copy b hereby famished. ❑ Certified copy Is filed wlIn y_bu2& No. FOR APPLICANT TO FILL IN BUILDING ADDRESS ;.: (PRINT OR TYPE ONL`) Date -ApplltaLOCALITY TYPE OF APPLIANCE OR EGM PME NT FEE CEIMRCAT�OF E)SYJWORKERS' tNEAREST _ COMPDCATICN INSURANCE CWOSS ST. ABSORPTION UNIT, BTU (7'hls sec in need not be compWt"If the work hnolwd by e the persntt!s w owe hundred dollars 01le 00)or ss.) no, 1 Alit HANDLING UNIT, CFM` / } { 1 certify *fiat In the perfoirnance of Ae work for which this A pprntft is Issued, I shall not employ any In any enanrW i; so Gs to become subfgct to the Workers�npersation Laws. BOILER BTU y,pMAJS ogre ATWE Dere Amlicarit COMPRESSOR, BTU ROLK3H 'r NOTICE,TO APPLICANT, If, after making this CedtftooWof VeNTRAT)ON SYSTEM RNAL Exemptldn, you should become subtleedct to the Workers' )ell oe ' compensation provhlons of the Labor'Code, you mud forthEVAPORATNE COOLER IDA-n N "with comp)y with such provisidrn or this permit shall be deem ti..ed rwoke� FURNACE: FAII LICENSED CONTRACTORS DECLARATION FLOOR' BTU 'I hereby affirm thbt I dm licensed under provisions of Chapter 9 ITER; SUSPENDED UNIT >'(commencing with Section 7000)of Division 3 of the Business WAIL and Professloro Code,and my IIcenn is IrtfuII forSLand effect. Itc Clan (L Lkenw NumbehT693 a t q•W hFl� ( O �. (Ca�ntrodar oC I� I am exempt under Sec O Plan ch6& fee C► W B dF C for this reason Dat.. PERNUT ISSUING FEE $ Z TOTAL FEE Signature OWNCR-aUILDER DECLARATION PLAN CHECK APPEICAW _ I hereby affirm that 1 am exempt from the Contractors Ucense Law for the following reason (Section 7031.5, Businella ¢red NAME Professions Codek V ❑ I, as owner of the property, pr my employees with ADDRESS- wages as their sols tompensation,wl I I do the work and CITY TEL. NO. s Acc.T the structure is rept IRtended or offered for sale(Secflon T . 7044, Business and Professions Code). OW NER❑ 00 1, as owner cf the property, am exclusively contacting - 1 ITM with licensed cor&octors to construct the project (Sec- MAIL tion 7044, Business and Profeasforrs Code) TOTAL 1(33_00 _. COt-�ON LENDING CITY TEL NO. I hereby affirm that there is a construdfon lending agency for CHECK 103.00 the perfprmcmce bf the work for whkh this permit Is Issued Cptnp-ACTOR ► .�{I (sec.3097, Civ. C. ADDRI 5S L Leaders Name +y±/pry CITY TEL. No. 0000-00101' ' 511,]/:U Lenders Address I certify that I have read this appllcatipn and state that the STATE CLASS NABS LIC. M59 1 All 7:iQ above Information Is correct. 1 agree to comply with all County and State laws relating to building corstrudion, and authortze repress vea of this County'to enter •abo anti for In purposes S@ RNtRif FOR EXPLANATORY LANGUAGE i ani of AQallcont or Pa*r;f Dale Ilki dC7RSLRS'(��1A1PEV5,CrIUYDECLARATION I CEA98(2.80) APPLICATION FOR PERMIT I hereby ufffrm that I itavt �jertiflcwe of consent to self Insure, or'r eettiticataof Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING a certlfled r ' t'eyrie i ric. GO. Lab.C.) Pulir No Nr' umpdn}' ❑ CertifiedCOUNTY OF LOS-ANGELES CORY hereby furnished. BUILDN AND SAFETY ❑ ) Certified copy Is filed with the countynspactioq BUILDING d art en . FOR APPLICANT TO FICC-FN Date ., Applicant (PRINT OR TYPE ONLY) Avg ADDRESS i NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY O CERTIFICATE OF EXEMPTION FROM WORK$RS', , COMPENSATION INSURANCE NEAREST } (This section need not be completed if the work involved ABSORPTION UNIT, BTU CROSS ST. o- by the permit is for qne hue red doUm ($100) or Lem) DISTRICT no: / rRor ssED ar 1 certify that in the performance of the work for which ;his AIR HANDLINP YNIT,CFM J i permit is issued. I shall not employ any person in any mpinner O to as to become subject to The WorLars' Compensation Laws. BOILER, BTU #TAW AV APPROVALS DATE ["P TORS SIGMA RE Data Applicant COMPRESSOR U _ a ' ROUGH to NOTICE TO APPLICANT: If.after making this Certificate of VENTILATION SYSTEM Z Exemption, you should become subject to the Workers' FINAL � ,.Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER with comply with such provislons or thLs permit shall be VALI deemed revoked. FURNACE: FAU QRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU I hereby affirm that l am licensed under provisions of Chapter HEATER: SUSPENDED UNIT 9 (commencing wlthc 7000) of Division 3 of the Bust- WALL neaaC31nd6TiiCod a, and mense is In Pull force andeffeLiceJ ..rr ��,,��Lic.CICon -UA17N&.te 112,11-94 from the Iicens requirements e.* I am a Iicensed [Hared professkmal engineer Plan pheck fee 25%of above. acting In my pr`oTFq7smv capacity (Section '7051, Bus- iness and Professions Code). PERMIT ISSUING FEE $ d 36 Llc.or Reg.No. Date TOTAL FEE HOME OWNER-BUILDER DECLARATION P,-AN CHECK APPLICANT I hereby affirm that I am exempt from- the Contractor's N AME License Law for the following reason (Section 7031.5. Buil- nes and Professions Code): ADDRESS �/.►v� y ❑ I, as owner of [he prpperty. will do the work and the structure is not Intended or offered for sale (Section CITY TEL. NO. 7044. Business and Professions Code). 1Ma50 ❑ OWN E R I, as owner of the property, am exclusively contracting 1 IIUf7 with licensed contractors to construct the project %'AIL TOTAL (Section 7044, Business and Professions Code). AODRCESS t TV 1 AL 188.50 CONSTRUCTION LENDING AGENCY CITY TEL.NO. MICK 18$.50 1 hereby affirm that there is a construction lending agency /� for the performance of the work for which this permit Is CONTRACTOR # SOV Issued(Sec. 3097,Civ.C.). Lender's Name ADDRESS Lender's Address CITY TEL.NO. 001D4-0001 7Ay/s17/ 9 I certify that I have read this ipplicatiun and etaV7[e that the STATE LIC. 4/ 1 AM10:52 above Information is correct. I Arae to comply with all County LI EN E NO. CLASS ordinances .end Stale laws rtg—ring Heating. Ventilating and ,kir Conditioning. and hcrebc rith.)ri,e representatives of this $EE REVERSE FOR EXPLANATORY LANGUAGE C'oun[y to enter :ipon the ,- •vt-rn ni,doned proper[}' for inspection n WORKERS" CO"PENSA11ON DECLARATION APPLICATION FOR P RIIAIT I hereby affirm that r have a certificate of corser`t to self Insure, or ICI �f,lf� ,�cogsatlan Insurance, HEATING VENTILATING - AIR CONDITIONING , y No�� oPw 9/8111kPollcCerl ' ' Corr►pany C04JNTY OF LOS ANGELES BUILD AND SAFETY ❑ Certified copy Is hefeby funbhed: ❑ Certified copy Is filed wtTthty bullding In FOR APPLICANT TO FILL IN BUILDING;�aa � fPRtNr oft TYPE otvtr) AD° IFRESS Do, AppikaLouury. X415 No. TYPE OF APPLIANCE OR EQUIPMENT FES CERnFr—ATE OF 1EXEMPTION F WOM36' NEAREST ,r COhkPIEN AWION INSURANCE CROS ST. n ot le I t (rhb.11k Reed ne corwplell B Rise stork W-A- d by ABSORPTION UNIT, BTU Dsrwcr NO. the perms is for one hundred&A—($100}or leak} _ r ALR FIATOfJtJGUWr,CFM ,I certify that In the,pufwmorice of &, work far whirr this pA 04rmit is ipued, 1 s)-gll not 0-p4ay any perp n In any manner `so ca To become subject to the Woriu Compensation Laws. BTU AaPta4+ts DATE SKPNIATURE COMPRESSOR, ETU ROUGH Date ArYJlcant NV MCE TO APPLICANT: ff, afW makl 91. Certificatet,9f - VENTILATION SYSTEM FINAL aemptrorr, you should become sulzfed 49 the Worker ' Compensation pravislorn'of fhe Labor Cgdej you must forth- EVAPORATIVE COOLER, V D With cam ply With such provWom or this permit i-holI be debar h dd revoked.- FURNACE-- FAU 'U CENSED CONTRAC i azs DECLARATION' Y FLOPIZ BTU "I hereFry affirm that I am Ilceraed under provfslons of Chapter 9 HFkEk &AWE A® UNIT -O'(comn-wmIrrg with Seption 7000)of Diyblon 3 of the Business W� and Profbsions Code,and my Ikense b in full and effect. { , CL License Numbe•tl I Ic Class , �•W JrAC� lam[ of Contrpctor O I atT1 exempt under Sec` F Plan check fee 1�.dP.C, for thisnasor d PERMIT ISSUING FEE ; Z TOTAL FEB -Sl�rwture OWNER-miRDUR DECLARATION PLAN a-EacAPPLI ANT I hereby affirm that I am exempt from the Contractors License oil.Law for tJre following realon{Section 7031.5, BusinessME and NA Profenfons Code}: ❑ I, as owner of lfre property, or my employees with ADORES s urges as$elr sole compernatton,will do the work and CITY T>� No. ACCT.T t sft ucture is not Intendoffered Intended or oeni7 d for sale(Section 3307 103,01 , Buslness and Professions Code} ❑ I,i�=owner of the property,am exclustveRy contracting - 1 ITEMS with Licensed the Io constn the project (Sec- MAIL ;Ian 70", Business and R-ofewarts Coe) TOTAL 11133-Q0 ATN t CITY TEL Na I hereby affirm that there is a construction lending agency for GECK 103.00 the performance of the work for which this permit b blued CONTRACTOR , �I .011 (Sot- 3097, ay. C. ' ADDRESS Lenders Name CITY TEL NO. iJ000�001 x/23%94 Lenders Address TATE I certify that I have read this appfloallon and stale that the LICE NO. � 1 Alt 7:lC1 above information is correct.1 agree to comply with all County noes and State laws relatitg to but(�ny oonstruction, and reby authorize r of this County to enter n abov endo for purPae& SEE REIFER4!FOR EXPLANATORY LANGUAGE r•�n* of q�l,rrrnr v Ar»nr Dara . 1t)Ithl:kS'&`1PE`S,�TIOVDFrLARATIOV CEA98(2.80) APPLICATION FOR PERMIT I herehy affirm that I ltava er �;rruficei of con ent to self 1 insure..br'a ceriiiicme of workers'C.,mpensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING a ctrtiti d c��there•, Sec 'A00, Lah. C I �}{ Policy tio'�4'—t 1mpany s" 6 ❑ Certlned copy is harehy furnished. COUNTY OF LOS ANGELES BUILDIW AND SAFETY ❑ Certined copy k(heel with Ithe county,h (ding Inspection d FOR APPLICANT TO FILL IN BUILDING IIAIVIGIX art an Date App,ceot (PRINT OR TYPE ONLY) ADDRESS CERTIFICATE OF EXEhiPTION FROM WORKERS' . 1140. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY COMPENSATION INSURANCE NEAREST >_ (TL6 section need not be completed if the tvork involved ABSORPTION UNIT, BTU CROSS ST. d by the permit is for one hundred, dollar; (S l00) or leas.) DISTRICT No. / PROC ED Y I certify that in the performance of the work for whlch this AIR HANDLING UNIT CFM JY permit is issued, I shag not employ any person in aqy manner 1 0 ? 0 to as to become subject to the Workers' Compensation Laws. BOILER, BTU APPROVALS DATE INan TDR S SIGHA RE Date -Appll"nr COMPRESSOR LU U ROUGH — NOTICE TO APPLICA"IT: If, after making this Certificate of % bENTILATION SYSTEM t Exemption, you should become subject to the Workers' FINAL IX Compensation provlsiont of the Labor Code, you most forth- EVAPORATIVE COOLER with comply with such provisions or this permit sholl he VALI O deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORSDECLAR-kTION FLOOR BTU I hereby affirm that f am licensed under provislons of Chapter riEATEFL: SUSPENDED UNIT 9 (commencing 6vitq__�rY '- 000) of Division 3 of the Bull- I WALL ness and Pr�fc igii Code. and m- ense is in full force and effect./� �� J �f-T— Lic `;u//tuber Lic. CI G//' L 140 IF Con ct-+r(a09ate ❑ I a xe from the hcenai ieyulramenb as I am a Hcensed c sterid professional engineer Plan check fee 25%of above. acting in my pro TI7ltSl capacity (Section 7051, Bus Ines;and Professiorts Code). PERMIT ISSUING FEE S Q Lic.or Rag. No. Date TOTAL FEE HOMEOWNER-BUILDER DECLARATION o_ay CHECK APPLICANT I hereby afTtrm that l am exempt from the Contractor's IiAME Licertsa Law for the following reuson (Section 7031.5. Busi- ne-ss and Profgssions Code): CDRE53 IDI, as owner of the property, %till do the work ind the 1 ACCM A structure is not intended or offered for We (Section CITY TEL. NO. � 7044. Business and Professions Code). 50 ❑ ::`liNER 01 ITEM 1, awn s owner of the property, am exclusively cun[ cting with licensed contractors to construct the project f•'.aIL (SeitlOn 7044, Business and Professions Code). ACDRESS TOTAL 188.50 CONSTRUCTION LENDING AGENCY CITY TEL. NO. CW1K 188.50 I hereby affirm that these Is a construction lending agency for the performance of the work for which this permit is Cr:-NTRACTOR OWE a00 Issued(S-c. 3097,Civ.C.). Landes's Name ADDRESS - Lender's Address 01010I.r'LMI 7/27/89 LTA TEL. NO. �p �t�t �+� l certif} that I have rea.i this application and ;tate that the LIC. 4749 1 AMIM52 above infurmatlon is corrnt. I.I}ree to conipl}'a ith all County SE 'JO. CLASS .nrdinrttes and State Ir. s regul.,ting Heating. Ventilating and Air C,>ndincwing. and h,.rcby Iut'rxize rcpresentati%es or this SLE REVERSE FOP EXPLANATORY LANGUAGE C,,umy to enter ur„n the nh• e m�n:l•,ned property fur in pecLn r� -