The URL can be used to link to this page

Home My Public Portal About5931 RENO AVE_Mechanical__ 7fl 'BA364,twelB-B-GB APPLICATION FOR PERMIT / HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ' e'v 0 COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITYCe G I NEAREST I FOR APPLICANT TO FILL IN CROSS ST. _L.Nrrl p S A- (Print or type only) OWNER NO.. TYPEJOF APPLIANCE OR EQUIPMENT FEE MAIL � ADDRESS M ABSORPTION SYSTEM, BTU CITY TEL. NO. AI.R HANDLING UNIT, CFM CONTRACTOR "rT L , BOILER, HORSEPOWER ADDRESS _ ® O 3 S' COMPRESSOR, HORSEPOWER CITY er wfj I TEL. NO.9a/3 FJ,3d� 1 VENTILATION SYSTEM L CENSE NO. a / CLASEC"'5 �S DISTRICT NO. GROUP ZONE" PROCESSED BY +" EVAPORATIVE COOLER f� FURNACE: FAU GRAVITY � '� FLOOR_BTU INSPECTION RECORD HEATER:.SUSPENDED UNIT WALL JS 14 : T-6 ��L � Rel a CD W O. y _ Z NEW—ADDITION— PERMIT. $ 3 00 ALTER—REPAIR— TOTAL FEE $ �O Plan check applicant Name Address L Tel. No. EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION TE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY L ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE ECTOR' SI TURE AIR CONDITIONING. ROUGH REBY CERTIFY THAT I AM NOT ACTING IN VIOLATION FINAL ER 9, DIVISION 3, OF THE BUSINES ND PROFESSIONAL THE STATE OF ORNIA. JACK R. ALLEN,S PERVI CHANICAL ENG'R. URE -PERMIT VALIDATIO cK. M.O. CASH MITT PLAN CHECK VALIDATION LACo 4 6 J 5 N IMR 1 4 1 D 8100- A ;EE ,00- ;EE BACK OF APPLICATION FOR COMPLETE FEE SQHEDULE 76A364—CE818-1/J0 APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES BUILD7- NEAREST DEPARTMENT OF COUNTY ENGINEER ADDRE BUILDING AND SAFETY DIVISION LOCAL JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF-BUILDING CROSS ST. FOR APPLICANT TO FILL IN OWNER " (PRINT OR TYPE ONLY) MAIL NO. TYPE OF APPLIANCE-OR EQUIPMENT FEE ADDRESS CITY TEL. NO. ABSORPTION SYSTEM, BTU CONTRACTOR AIR HANDLING UNIT, CFM. ADDRESS .g BOILER, HORSEPOWER,952�, T) CITY T 0. COMPRESSOR, HORSEPOWER STATELIC. LICENSE NO. CLASS VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE PROCESSED BY EVAPORATIVE COOLER J,D Ip FURNACE: FAU_GRAVITY INSPECTION RECORD FLOOR BTU HEATER: SUSPENDED—UNIT— WALL USPENDED UNIT_WALL 0 C C. " - o C e PERMIT $ 3' 00 u NEW—ADDITION— cl e_ ALTER—REPAIR— TOTAL FEE S 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 DAT5 I ECTOR'S SIG TURE LATINS,AIR CONDITIONING. ROUGH � � ZZ 1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL 1� CODE OF THE STATE OF CALIFORNIA. _� 11 SIGNATURE JACK R. ALLEN,SUPERVICCK)jW ICA�e ENG'R. OF PERMITTEE PERMIT VALIDATION �• CASH PLAN CHECK VALIDATION . LA10 1 3 4" J/6426 4 1 D 1 0.50- SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE t 'WORKERW COMPENSATION DECLARATION ' Whereby affirm that I have a certificate of consent to self APPLICATION FOR PERMIT • insure, or a+certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified copy thereof(Sec. 3800, Lab. C.) 76A364C CE-818(REV. 10/81) Policy No. Company 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 �- tion department. ADDRESS • • (PRINT OR TYPE ONLY) AM Date Applicant LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE 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. PROLES D Y the permit is for-one hundred dollars($100)or less.) l} Q� 1 certify that in the performance of the work for which this AIR HANDLING UNIT,CFM / (J o permit is issued, I shall not employ any person in any manner so ds to become subject to the Workers'Compensation Laws. BOILER, BTU APPROVALS DATE INSP C R'S SIGNATU COMPRESSOR,BTU ROUGH Date �/0-'��4pplicant 6A1 Gi+ 1V7, DY + NOTICE TO APPLICANT: If, after making th Certificate of VENTILATION SYSTEM FINAL Exemption, you should become subject to the Workers, Compensation provisions of the Labor Code, you must forth-' EVAPORATIVE COOLER I AI InAT' N with comply with such provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT '(commencing with Section 7000)of Division 3 of the Business - WALL and Professions Code,and my license is in full force and effect. L ,l (J O License Number Lic. Class _ G ► U 09 Contractor Date ❑ I am exempt under Sec. Plan check fee H B.&P.C. for this reason' PERMIT ISSUING FEE$ Date: - Signature TOTAL FEE • OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License ) � // T/ �[[ , �6 3 6 2.A Law for the following reason (Section 7031.5, Business and NAME G/71GMG(42 J�/�H f'f0� Professions Code): &4,� Q , # 00'a008 ADDRESS ❑ I, as owner of the property, or my employees with , wages as their sole compensation,will do the work and CITY s TEL. NO.C(�y� —�7/S °o as _ the structure is not intended or offered for sale(Section 7044, Business-and Professions Code). OWNER0 1'2 0-8 7 D9I,as owner of the property, am exclusively contracting -'� �t"s d'L D v-e-. " with licensed contractors to construct the project (Sec- MAIL tion 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY TEL. NO. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CONTRACTOR p� , (Sec. 3097, Civ. C.). ADDRESS , Lender's Name CITY• TEL. NO. Lender's Address STATE LIC. I certify that I have read this application and state that the LICENSE NO. CLASS above information is correct. I agree to comply with all County ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter upon the above-mentio d pr rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -Signature of plicant or Agent Date