The URL can be used to link to this page

Home My Public Portal About5600 GRACEWOOD AVE_Mechanical__ 7GA.M4G Gi-E Ii IRl'v. m� APPLICATION FGR PERMIT HEATING - VENTILATING - AIR CONDITIQ,NING COUNTY OF LOS ANGELES BUILDING.AND.SAFETY fNE LDING FOR APPLICANT TO FILL IN ADD (PRINT OR TYPE ONLY) ALITY. NO. TYPE OF APPLIANCE OR EQUIPMENT FEE REST D SS ST. ABSORPTION UNrT.BTU OWNER AIR HANDLING UNIT,CFM MAIL _ 1 ADDRESS FU Crfl'� TEL NO. COMPRES pop 4Q CONTRACTOR t VENTILAT ADDRESS Lk7 'egj)2 / EVAPORATIVE CO"QLJER CITY TEL NO. &. S FURNACE: FAU GRAVITY STATE LIC. FLOOR BTU LJCENSE NO. CLASS HEATER: SUSPENDED UNI-T_ MP�y,� DATE I 'ssKluruae W AI I ROUGH i FINAL INSPE TION u c 0 Plan check fee 25% of above. PERMIT ISSUING FEE _ TOTAL FEE PLAN CHECK APPucArrr PLAN CHECK VALIDATION NAME ADDRESS O'D CITY TEL NO. IHEREBY ACKNOWLEDGE THAT I HAVE READ THLS APPUCAT10N AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WfTH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR ' CONDITIONING. PERMIT VALIDATION'' $4.9 7,8 A I HEREBY THA A.M. NOT T1NG IN VIOLATION OF CHAPTER 9, ION S, BUSIN D SSIONAL CODE '# o o • 0 4. 1 OF THE ST OFC IA- 8 A. 81GNATURE L 1� 1 8.9,0 0 OF PCRMITTEP . DISTR}CT NO. _ PRocrbas.D eY o•a 1 8 9, 0 0 6S' - w� 0 6 1 8'-7 9 . lib'COMP NE SATION DECLARATION �". TC�654C18 80) APPLICATION FOR` I� E R M 0 I rr' •than I have a' certlflcste of consent to self It r ecertlftcate-of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING a c4tifled copy thereof(Sec. 3800,Lab.C.) Policy No.-Company Certified copy is hereby furnlshed. COUNTY OF LOS ANGELES BUILDING ARID SAFETY �. Certlflad copy Is flied with the county budding inspection BUILDING art' nt 1, {+ 1 V 1 j FOR APPLIGANTTO FILL IN ADDRESS C Date lAppllcant�«`r • ■tlkk'A 1i (PRINT OR TYPE ONLY) LOCALITY t CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE COMPENSATION INSURANCE NEAREST (Thlf lection deed nbt be completed if the work: Imotved ABSORPTION UNIT, BTU CROSS 3T. by the permit Is for one hundred dollars (1100) or less.) DtSTRICT No. P BY I certify that in the performance of the work• for which this AIR HANDLING UNIT,C.FM `V Y permit is lsspad, I shall not employ any persgn In any manner ecome subjdct to the Workers' Comparustlon Laws. BOILERBTU V Q B U so, ds to b // ,aPPROVALS DATE R NATURE Date Applicant COMPRESSOR BTU O vo _J ROUGH NOTICE TO APPLICANT: If, after makinj this Certificate of VENTILATION SYSTEM Exemption, you should becomte subject' to the Workers' FINAL Compensation prorlslons of the Labor Code, you must forth- with comply with such provision or this permit &hall be EVAPORATIVE COOKER VALIDATION deemed revoked. FURNACE: FAU ISA ITY LICENSED CONTRACTORS DECLARATION FLOOR: . BTU L 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.. _ License Number 31 Lic. Clnss 11 Contractor Ce b;Date mrequire I am exempt frothe llcvvensing requirements as I am a. #41'1 licensed architect or a registered profeasional engineer Plan check fee 25% of above. actkng In my profeasiowl capacity (Section 7051, Bur • • 5 Q 5 0 Ineu and Professions Code). PERMIT ISSUINU` FEE $ • •.. 5Q506 Lic.or Rag.No. Date TOTAL FEE 12'0 4+,8 4 HOME OWNER-BUILDER D$CLARATION PLAN CHECK APPLICANT I hereby affirm that ].am exempt from- the Contractor's iNAME �h , £ License Law for the following reason (Section 7031.5, Buri- a. neas and Professions Code): ADDRESS I, 'as owner of the property, will do the work and the 88' structure Is not Intended or offered for Sale (Section CITY Ed TEL. 7044, Business and Professions Code). . I, as owner of.the OWNER � K property, am exclusively contracting wlth licensed contractors to construct 'the project MAI L (Section 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY ; TEL.NO., I hereby affirm that there Is a construction lending agencyy for the performance of the work for which this permit is CONTRACTOR CQ Issued (Sec.,3097,Civ.C.). . ' Lender's Name ADDRESS Lender's Addreu CITY 0 TEL. N I certify that I have read this application ■ad state that the STATE LIC. above Information Is correct. I agree to comply with&11.County E N CLASS ordinances and State'laws regulating Heating, Ventllafing and Air Conditioning, and hereby authorise representative&of this SEE REVERSE FOR EXPLANATORY LANGUAGE .County to enter up o the above-mentioned property for Ycoon par Signature of Permittee Date _ _- WORKERS'COMPENSATION DECLARATION CEA 881 8 (2-80)- APPLICATION- iPPLICATION G'— ORPERMIT I hereby affirm that I have e' certificate of consent to self insure, or a,eertlflcate of Workers'Compensation Insurance,of HEATING-VENTILATING-AIR CONDITIC)NING IL certlfled p r o Sec. 3800,Lab.C.)(� Policy No4mlompanyS2 11 Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AMD SAFETY Cortifi py is flied with the county building Inspection .d FOR APPLICANT TO FILL IN BUILDING C"57ORACE WWP Date Applicant P, -F1;ALJ I (PRINT OR TYPE ONLY) ADDRESS �J G,`1 NO. TYPE OF APPLIANCE OR EQUIPMENT, FEE LOCALITY CE/TI 4CAXE OF EXEMPTION FROM WORKERS' 4 G COMPENSATION INSURANCE NEAREST 6R038 8T. r1AK (This section seed.not be tompleted if the work b]vohrod ABSORPTION UNIT, BTU V by the permit is for one hundred dothm (5100) or lest.) DISTRICT No. PROCEMED BY I certify that In the performance of the work for which thH AIR HANDLING UNIT CFM O� o permit Is Issued, I shall not employ any person In any manner U so as to become subject�o the Workers' Compensation Laws. BOILS BTU APPROVALS DATE INWE=RYSIGNATURE lJJ DataT Applicant COMPRESSOR BTU _ ROUGH NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM �� FINAL 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: BTU I hereby affirm that I ■m licensed under provisions of Chapter ., HEATER: SUSPENDED. UNIT 9 (commencing with Section 7000) of Division 3 of the Busl- WALL ness and Professions Code, and my license Is In full force and effect. License Number Lic.Class Contractor Data ElI am exempt from the 11"rising requirements as I am a Ilcerued architect or.a registered professional enginebr Plan check fee 26%of above. acting in my professional capacity (Section 7051, Bus- Iness and Profeaafons.Coda). PERMIT ISSUING FEE$ Lic.or•Re'g.No. Data TOTAL FEE HOME OWNER-BUILDER DECLARATION PLAN CHECk APdLICANT ' I hereby affirm that .1 ■m exempl from- the Contractor's NAME Licen;e Law for the following reason (Section 7031.5, Busi- ness and Professions Code): ADDRESS 0 1, as owner of the property, will do the work and the �rb;biEl1 1 structure is not Intended'or offered for sale (Section CITY TEL. NO. , ) 7044, Busfness and Professions Codb). #�0 0 0.0 0 8 OWNER OI. as ownef of the property, am exeluslvely contracting 9 Zr6.a 3&'5 0 with llcdnsed contractors to construct the project MAIL - Section 7044, Business and Professlons Code). ADDRESS-5 CONSTRUCTION LENDING AGENCY CITY C TEL.NO. 03)0 (� 5' . 2 I hereby affirm that- there Is a construction lending agency �+ for the performance of the work for which this permit is CONTRACTOR Issued Sec. 3097,Civ.C.). Lend or s Name - ADDRESS 30 RL_ Lender's Address CITY TEL. NO.aW 1-7,5 I certify that I have read this application and state that the STATELIC. �. a above Information is correct. I agree to comply with all County CLA88 ordinances and State laws regulating Heating, Ventilating and Air Conditioning, and hereby authorize representattves of this. SEE REVERSE FOR EXPLANATORY LANGUAGE County .to enter upon the above-mentlo d operty for sp ion purfipa{�s. 1 11/42 4 ; 1 azure o P�rmlttea Date