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HomeMy Public PortalAbout9428, 9426 LAS TUNAS DR_Mechanical__ I hereb O aKERS' 76A364C nnp , OMPENSATION DECLARATION CE-818 (2-80). :t[— I(- L� /r=�T II u VO If1C. Ir LS If�C U�%ll' y: t I• have a' cehificate,of consent to self insure, or'a certificate of Workers'Compensation Insurance•o"r: :. TIIfl a certified cow the*eof(Sec '380h.Lab C _ -� ()� /� 4�ilE�a �G-!l�IiIYIL.P-�T'1� 14@ G®�®IYI�I�IIR'IG =. Policy No� ��_COmpa. _ST�E 66 L, r N� � ertffied'copy is hereby Furnished,.. " fi COUfiiTY OF„LOS ANGELES'. BUILDING MD.SAFETV Certified copy-is filed with,thecounty building inspection ' BUILDING _'dpp t t, FOR APPLICANT TO FILL TT _ � 0 Applicant A lN'G:` O tPRINT.'OR"TYPE ONLY') 4 N — ADDRESSL./j� A ���• Dat e, C RTLFICATE.OF EXEMPTION-FROM-WORKERS' NO. TY:P.E OF.APPLIANCE OR EQUIPMENT FEE LOCALITY 4 ` COMPENSATION INSURANCE NEAREST' e. . , CROSS ST. . (This section need not be corhpieted if the work•:inyolved' ' - ABSORPTION•UNIT; BTU - p by the.per nrt .is'for.,one hundred"dollar's`($`100) or less.)', ,, DISTRICT NO. PROCESS F>,BY I certify that rn the performance-•of the work-for which this. AI'R_HANDLING UNIT,CFM . V permit is issued', I shall not employ any person in any manner, so as'to become subject to the Workers' Compensation Laws. BOILER, BTU _ 0. ' INSPECTOR'S SIGNATURE I R l COMPRESSOR BTu4&0©© ROUGH AP CL. PROVALS DATE Date Applicant NOTICE.TO APPLICANT':,If,#after making this Certificate-of P VENTILATION SYSTEM r Exemption,"you-should become, subject. to the Workers' r FINAL Compensation provisions of the Labor Code,you must forth- " with comply with such provisions or this permit,shall.be EVAPORATIVE COOLER , deemed-revoked ✓/ .��• IT1 f VALIDATION I PLO R. FAU BTU—IpC7�Oob LICENSED CONTRACTORS.DECLARATZON'J hereby affirm that"1,am licensed under provisions of Chapter - _ HEATER: ,SUSPENDED UN IT 9' (commencing with 5ection.7000)of Division 3 of the.Buil- w WALL ness and Professions Code, and-my license is in full force-,and ; ° effect: (`�'� � , - LicenseNumber_�V-V�n_ Lic::Classv^ �/ Contractor_ Ci 1� �rl�_ Date—7,, '"I am exempt from the.licensing requirements as I am a licensed .architect or a registered,professional engineer Plan check fee 25%of above. acting in my professional.capacity (Section 7051 Bus? _ iness and Professions Code). PE RMIT ISSUING f'EE'$ —= I ic.or Reg:'No. "Date TOTAL FEE C! HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that,�I''am exempt from- the Contractor's''",� NAME" License.Law;for'the following'reason •(Section 7031.5, nessand'Professons'Code)'- ADDRESS,' OI as .owner of,the property,'will do the work and the structure is not• intended or,-offered,fp`r sale (Section.. C1T'Y TEL. NO. 7044-,.Business and Professions Code). z 2 9,R I, as owner of the"property am exclusi OWNER vely contracting _ '� I—� '• # a`o�o'olod8 � with licensed.'-contractors t6"Construct.”, the 'project MAIL ! I (Section 7044,Business and Professions Gode). ' 2 0 o l� ADDRESS OONSTRJJCTION LENDING AGENCY' CITY :. TEL.NO. 2` O Fi hereby,affirm-that- there is' a°construction lending agency- _ "� . -- � - o+o o r21 • Oyu for,the -performance of the'-work for which this permit is. CONT .ACTOR��`I.f? a 1 N G _?�fl issued (Sec: 30.97,Civ.C). 7� .i $:1 Lenders Name - ADDRESS . Lenders Address m�13SLy F CITY" MID z O V IA-- I°certify that I have.read this application a-nd`state that the STATE Q LIC,_ — above information is correct:I agreeto comply with all.County LICENSE'N6. ��_Q CLASS 1� __,0 ordinances,and State-laws;regulatin' Heating, Ventilating antl r Air*Conditioning,,and hereby'authorize.representatives,of this, SEE REVERSE-FOIL EXPLA,hIP.TORY LANGUAGE' nt.y to enter ur on a r,u' mentioned properiv for nip cte purpos S' nature`of Permitt Dat