HomeMy Public PortalAbout4937 ROBINHOOD AVE_Mechanical__ 76A364 - CES18 - 3-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION t ,
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
• CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CIT TEL. NO.
AIR HANDLING UNIT, CFM CONTRACT 7 /1
ADORES `ems
BOILER, HORSEPOWER
CIT EL. NO
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE ESSED BY
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY
FLOOR BTU INSPECTIO REC D
HEATER: SUSPENDED UNIT
WALL
0
rSG+ L
u
NEW—ADDITION ERMIT $ 3 00 v
L_
ALTER_REPAIR_ TOTAL FEE $ tc)
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.N0.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
LHATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ORDINANCES AND LAWS REGULATING HEATING,VENTI- pppROVALSDATE INSPECTOR'S SIGNATURE
IR CONDITIONING.BY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION OF ROUGH
9, DIVISION 3, OF THE BUSINESS AND PROFESSIONA•V FINAL
HE STATE OF CALIFO NIA.E JACK R. ALLEN, SUPERVISING ECHANICAL ENG'R.
TTEE
PERMIT VALIDATION cK. M.D. CASH
PLAN CHECK VALIDATION
` Ar 1 2 8 6c JUL 7 4 1 D 10.50,
=E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
N()Ill(FRS'C0NIPI.NSA1[ON DE'C'IA:t.I,'1ION 10EA818 (2-80) &A-1%PPUC!^1,T�ON FOR PERIIV T
1 herehy .,itlrm that I hate if certificate of consent to self
ar a certificate 111\\'Orl(Nr. Compensation insurance.orIc HEATING-VENTILATING-AIR CONDITIONING
Certified corn is hereby furnish.;d. �d. COUNTY OF LOS ANGELES BUILDING ARID SAFETY
,
I
C Lttiti,:d .opy is filed with the coo '. uildin.inspection i FOR APPLICANT TO FILL IN BUILDIN
I);,, '" -4p�lic.,nt _ (PRINT OR TYPE ONLY) ADORES
LOCALITY
CLRTII ICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
I- _?
COMPENSATION TNSURANCE I NEAREST
(1'Itts section need not be completed if the work involved ABSORPTION UNIT, BTU CROSS ST. a
bl th,- pe-.mii is for ore hundred dollars (S100) or less.) DISTRICT NO P ED U
1 (citify th„t in the pertorntancu of the work for which this AIR HANDLING UNIT,CFM /f 1r
,lit is issued. I shall not employ any person in uny manner i
sc .ts to %ec qane subject to the Workers'IC .�777777aaa000,satio�f�lLaws. BOILER,BTU
�ar`{ � ,APPROVALS DATE INSPECTOR'S SIG URE U
I)at. til
Applicant�`f / �(vy���l COMPRESSOR,BTU
ROUGH a
Nol'ICI. TO .APPLICANT. It, after making this Certificate of VENTILATION SYSTEM FINAL OA Z
I etmptlon, you should become subject to the Workers'
Compensation provision; of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATION
N%ah comply with such provisions or this permit shall be
deemed revoked. FURNACE: FAU GRAVITY—
LICENSED
RAVITY LICENSED CONTRACTORS DECLARATION FLOO BTU
I 'it•retiv affirm that I am licensed under provisions of Chapter < H.EATE SUSPEN;ft UNIT
9 (commencing with Section 7000) of Division 3 of the Busi- ! WALL
ness and Profe:cions Code. and my license is in full force and
y I
1 it nst•Number. . — l,ic.Class �
C ntracto.�_ Date
I .I
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer Plan check fee 25%of above. +I
acting in my professional capacity (Section 7051, Bus-
inessnd P�f(, ttC�ia` PERMIT ISSUING FEE
Lic.or Reg.No ,_ U Date — TOTAL FEE
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractor's NAME
I icense Law for the following reason (Section 7031.5, B.usi-
nc,s and Professions Code): ADDRESS 8806 EAST I AS TUNAG
9 1. work and the w
1as owner of thero property, ; � 8
n p p' y' will do the CITY SAM GABRIEL, C�11_I'' FMf~LF1bS:l' P
structure is not intended or offered for sale (Section
7044, Business and Professions Code). ii OWNER 0 0 0 0 0 8
I, as owner of the property, am exclusively contracting it
with licensed contractors to construct the project MAIL 2 o 0 3350
(Section 7044, Business and Professions Code). ADDRE I)
0 0 0 i a5 l:t=.t
CONSTRUCTION LFNDING AGENCY CITY � � TE
I hereby affirm that there is a construction lending agency r, 1 8-82
for the performance of the work for which this permit is CONTRACT
isaued(Sec. 3097,Civ.C.). , MI IFOR !1A ne%r%o eft aft.-
- ,
Lender's Name ADDRESS 8808 EAST LAS TUM
AS DRIME
Lender's Address CITY SAN BRIEL,-CALII�QM 811778
1 certify that I have read this application and state that the STATE LIC.
ut•utc information is correct.1 agree to comply with all County LICENSE NO. CLASS
ordinances and State laws regulating :-seating,Ventilating and
A'r Conditioning,and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
ounty to enter the above-mentioned property for
u •. n purpos.
'i; a ere of Permitt Date