HomeMy Public PortalAbout9658-9660 LAS TUNAS DR_Mechanical__ 76A364-CE81 8-1/70 "It"
• y'T'`�:
t-1 �' ` ON ' R �.ERMIT
BEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER -
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING •NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAI L
9/96
NO. TYPE OFAPPLIANCE•OR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION SYSTEM, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM ADDRESS ��ry
BOILER, HORSEPOWER CITY TEL. NO �/5/ /
COMPRESSOR, HORSEPOWER QQ STATEEv LIC. ^4O
LICENSE NO. CLASS/y
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE I PROCESSED BY
EVAPORATIVE COOLERIL
FURNACE: .FA GRAVITY
FLOOR BTUINSPECTION RECORD
'
HEATER: SUSPENDED UNIT_
WALL
a
C
c
o
c
f
c
NEW-ADDITION- PERMIT $ 3 00
ALTER-REPAIR- TOTAL FLE $ 13-
5D
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS'CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
. ROUGH
I HEREBY C RTIF HAT 1 AM NOT ACT[ VIOLATION
OF CHAPTER 9, D N 9, OF THE:B ESS D OFESSIONAL ' FINAL Z.
CODE OF THE STAT F LIFORNIA.
SIGNATURE JACK R. ALLE ,SU ERVIS ECHANICAL ENG'R.
OF PERMITT
<. PERMIT VALIDA O K. M.0. CASH
PLAN CHECK VALIDATION
'Aug 31 4 1 1.5.5 0�
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT
I hereby affirmI that I have a certificate of consent to self
insure, or a certificate of Workers'Compensation Insurance,• HEATING - VENTILATING •- AIR CONDITIONING
or a certified copy thereof(Sec. 3800, Lab. C.) CE-81 C
`,, (CE-818(REV. 10/81)
ololicy No. /-7 Company�/ S-2 (10 W es_r
Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING(PRINT OR TYPE ONLY) �6�� y—
tion department. ADDRESS /ff/v
• �t�r/✓ LOCALITY 7'
~ NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
Date Applicant r
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION INSURANCE CROSS ST.
(This section need not be completed if the work involved by ABSORPTION UNIT, BTU DISTRICT NO,
PROCESSED BY
the permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
I certify that in the performance of the work for which this L/✓/
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. BOILER,BTU �f APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant COMPRESSOR, BTU p 0 D �'� ROUGH
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL J"
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 RAVITY vii,i D
LICENSED CONTRACTORS DECLARATION J— FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: • SUSPENDED UNIT
'(commencing with Section 7000)of Division 3 of the Business WALL
and Professions Code,and my license is in full force`3�and effect.� � _ IL
O
X0373 S �`
License Numberq01373 Class $C'T
®C
Contractor (Po A1631f C_ Date
❑ I am exempt under Sec. IU
Plan check fee �
B.BP.C. for this reason'
Date: PERMIT ISSUING FEE $ 4
TGI
Signature TOTAL FEE
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and NAME
Professions Code):
❑ I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the Work and
the structure is not intended or offered for sale(Section CIN TEL. NO.
7044, Business and Professions Code).
E] 1,
as owner of the property, am exclusively contracting OWNER Note St
with licensed contractors to construct the project (Sec- MAIL /n�
tion 7044, Business and Professions Code). ADDRESS Q /J 0 `r �l' n
CONSTRUCTION LENDING AGENCY CITY 7f- �i TEL. NO. y' o ° ° ° °
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued CONTRACTOR ^/0!'Z 2 a o v'0'v Q
(Sec. 3097, Civ. C.).
ADDRESS -�7 � ,`il1%
i
Lender's Name _ � 7 C.�__ � LL
ESTATE
��` TEL. NO. V(Jr a y
Lender's Address
• �? LIC. C 3 9 $�o�D
I certify that I have read this application and state that the NO. V63735-5- CLASS
above information is correct. I agree to comply with all County I
ordinances and State laws relating to building construction,
and hereby authorize representatives of this County to enter
rubt e aode m ed property for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date
\�UKI;rm th'Ul;=;*'.4, CEABis(2-80) �PP LL ^CATION FOR PERMIT
I hereby aff;rtb i; I ;;;�a •� stir,;'. • + c;rncan t to ,elf
insure,or a certifrcateo}1•ur., , 11. u., „m Insui.l.)c;,''r HEATING-VENTILATING-Alla CONDITIONING
a certified copygthei -or(c;c 3:'1)4 r u•
Policy No. e L 1 INtnnp i,i` tC)�j�).;L)I.c –J�,1G ;Ill
❑ Certified copy is hereby full,, 1.d COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified cop) is filed with the counts build,- inspection .t
departm,n (� FOR APPLICANT TO FILL IN ADILDING DRESS en s �uN�s
Date `I;' 4pplirant_�r�~X�'�z.121 (PRINT OR TYPE ONLY)
LOCALITY 7P�1R@ f
CERTIFICATE OF i.1ci�mP'rir I ;;()11,,f lei RS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPYNS\TR) R'_\t'r _--- NEAREST
CROSS ST.
(This section need not be co:,1)f,_!etl if the work involy d ABSORPTION UNIT,BTU a
by the permit is for Ole 11t11;aS:d dollar:, S;(16) OI less.) I DISTRICT NO PROCEqEqFBY O
I certify that in the per!orrramL or the ,,.oils fur ,,Onch this 'AIR HANDLING UNIT,CFMe: r Y Q
permit is issued. I shull nut emriny any perco,i n)an,. manner U
so as to become suhjcct t:, (.I,! 4turi•cr,'C'oripcnsation L.ws. BOILER, BTU O
Date Applicant__ _ _ APPROVALS DATE INSPECTOR' IGNATURE V
Pp ( COMPRESSOR,BTU ROUGH
7 W
NOTICh TO APPLICANT: It, •rtter mailaril, thi% Certificate of VENTILATION SYSTEM ^G�r y
Exemption, you should btzonie suhjuct to the Workers' FINAL 2
Compensation provisions of the Lr'-,)r C'orlt, you roust forth- EVAPORATIVE COOLER
with comply with such pr•)Yisiom thr, permit ;hall he VALID ION
deemed revolted.
FURNACE:^ FAU GRAVITY
LICENSED CONI R 4;ioRS 11;C LAR Al ION ( FLOOR BTU �
I hereby affirm that I am liecmc,i Under ornvision%of Chapter HEATER: SUSPENDED UNIT
9 (t,ommencing with Section 7000)lit i)lesion 3 of the Busi- I WALL
ness and Professions Code,ane my 1 cane- is in full force and
effect. JJiJ...�1111 p
License Number—V()-??i T r, l'la, _C31
Contractor0JNas2 Date- ( S — # 1 6 7 8 8
a a o 0 0
❑ I am exempt from the I-ren,anl, reyu.rcUlents as I am a a 0 3 Q 5 0
licensed architect or a re-i,terM professional engineer Plan check fee 2590 of above.
acting in my profc%sionA capacity (Set•tiun 7051. Bus- -- 0 0 0 3 Q 5 0 v
iness and Professions Colle). PERMIT ISSUING FEE
Lic.or Reg.No. ____—halt- TOTAL FEE60 0213-85
FiONIE OWNER-BUII.DLR DI'CLAR ATION PLAN CHECK APPLICANT
I hereby affirm that I am a%empt from the Contractor's NAME
License La„ for the follow'TIV le:_,011 (Section 7031.5, Busi-
ties%and Profession.,Code)- ADDRESS
❑ 1, as owner of the orop.-ith, v.01 do the wort[ and the CITY TEL.NO.
structure i, nut inti nJvJ u• of t;rt J for sale (Section
7044, Business and Piofo%su)n,Code) -----
❑
1, a% owner of the pro{.criy, acxus,vcly contracting OWNER
� �• r!7 PLS
wim t.l
th licensed contractor, 1'r construct the projectMAIL
(Section 7044,Business and 1110Q%%100%Code). ADDRESS
CONSTRUCTION LT N1 ING '1L,l N(y CITY `jpA- 'Jr P r'7/y TEL.NO.a s �p�
I hereby affirm that there is a 1.011-41U01011 Icndu)y, agency [ � �
for the performance of the ,tont toi uhien this m
perit is CONTRACTORAle
issued(Sec. 3097,Civ.C). - - - -
Lender's Name_ __ _ _ _ _ ADDRESS "..q Al
C
Lender's Address-----_--____ Rnl�
Y eev/� /. TEL.NO.
e
I certify that I halread thr. .:p1+1•i.,lran ,'vd ••idic that the ATE/ L LIC.
above informutiun is correct.l.i(.,ct W.air11'1y i%Iln,ill Count) F-NSFNO. w�73 CLASS
ordinance% and Starte la,c, re,.Ul,om, I+,•,ire' . Vedtiloting and
Air Corlditroninf,and herthy authr,,,� .:I*,;,sots tl.i,of this SBI RI-VIRS1 FOR EXPLANATORY LANGIrAGF
County to enter upon the ,.ho,. ,„cut o 1:J prorwri) for
m ect” n purport
Signature of Permittee -)air