HomeMy Public PortalAbout10650 SPARKLETT ST_Mechanical__ 76 A964- CE BIB- S-]3 -`
AP CATION F"IT
MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
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 UNIT BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
CITY TEL NO 3 O
COMPRESSOR BTU STATE LIC /1
LICENSE NO It Qf CLASS C
VENTILATION SYSTEM DISTRICT No I GRouP zONE PRO SSED BY
EVAPORATIVE COOLER
FURNACE FAU X GRAVLTY
FLOOR BTU (f u INSPECTION RECORD
HEATER SUSPENDED—UNIT—
WALL
T
CIL.
8
s
O
H-
U
W
CL
H
Plin check LD 2S% of rho%l See reYer.e z
PFRVIII 1�4UIN( FF [ S 3 to
IOIAI FLE
PLAN C CK APPLICANT
NAME
ADDRESS
CITY NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCESAND LAWS REGULATING HEATING VENTI APPROVALS DATE INSPECTOR S SIGNATURE
LATING AIR CONDITIONING
ROUGH
IHEREBY CERTIFY THAT I AM NOT ACTINO IN VIOLATION
OF CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROIESSIONAL FINAL
CODE OF THE STATj�Q[CALIFORNIA
slcrvnT URE \C\Yl/\I PERMIT VALIDATION CK M D cASH
OF PERMITTEE
PLAN CHECK VALIDATkON CK M G CASH
0 441 O 8.00u`o
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS COMPENSATION DECLARATION 21)-03411 DPW 9fw APPLICATION FOR PERMIT LIME GREEN
I hereby affirm that I have a certificate of consent to Bell Insure 7f1ti3MC
or a certificate of Worker a Compensation Insurance or a certified HEATING-VENTILATING-AIR CONDITIONING
copy thereof�(SSac3300001 b C B j(-oil 0 - - -- -
0 No wzZ/L Company
Cartifted copy is thereby furnished /�/" COUNTY OF L03 ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
ry/ /�-
LJ
Certified copy Is filed with the county building Impaction FOR A(PPPLIPRINT CCA NT TO FILL IN ADDRF� 4s/-
Data Appikant NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
CER FlCATE OF EXEMPTION FROM WORKERS �EARESTROSSb-y
COMPENSATION INSURANCE ABSORPTION UNIT BTU p.r /}y p �/
(This section need not be completed If the work Involved by the ASS BOOK SSO J pAO�`/ pAgCELB�7
permit Is for one hundred dollars($100)or leen) AIR HANDLING UNIT CFM MAP
ohemcr so aRoceasEn ar
I certify that In the performance of the work for which this permit r
is issued I enot employ any person iany manner oro as to BOILER Hill
become subjectct to the Workers compensation Laws QS
COMPRESSOR BTU
Awrw,vs DATE Na 6810,0n
Date Applicant %'ENTILATION SYSTEM
NOTICE TO APPLICANT If after making this Certificate of ROUGH
Exemption you should become subject to the Workers Compensation EVAPORATIVE COOLER
provisions of the Labor Code you must forthwith comply with such FINAL
provhehons or this permit shell be deemed revoked FURNACE FAU
LICENSED CONTRACTORS DECLARATION FLOOR V LI ATION _
I hereby affirm that 1 em licensed under provisions of Chapter 9 BEATER SUSPENDED—UNIT—
(commencing
USPENDED UNIT_(commencing with Section 7000) of Division 3 of the Business and WAIL
Professions Code and myylicense Is in full force and effect
License Number -Sp2*/J9"Ir tic"Cissa L2o
Jr
/ t('� a.
Contractor �7Vf.'-C-.Ftv Q
❑ I ePlan check fee U
em exempt under Sec
B 3P C for this reason PERMIT ISSUING FEES 7 O
Date TOTAL FEE W
Signature G.
OWNER-BUILDER DECLARATION PLAN APPLICANT ' Z
NAME
I hereby affirm that I am exempt from the Contractor s License Law - }
for the following reason (Section 7031 5 Business and Professions , A�^Tra
Code) ADDRESS ACCT.0❑ r�rI as owner of the property or my employees with wages 3W 48.00
as their sole compensation will do the work and the CITY TEL NO - -
structure Is not Intended or offered for sale (Section 7044 1 ITGIh7l'
Business and Professions Code) OWNER 4 CO TOTAL �$i.�0
❑ I as owner of the property em exclusively contracting - 7-10" y�y�
with licensed contractors to construct the project (Sec MAIL
Q / f - -T �eW
tion 7044 Business and Professions Code) CLACK _ W'
CONSTRUCTION LENDING AGENCY CITY' C/ TEL NO D 6Jff' h yApY1VG .00
hereby affirm that there Is a construction lending agency for --
the performance of the work for which this permit s Issued IYIINTRACTOR
(Sec 3097 Cw C) !e .yyy�..�y�� 8/27/92+� �pAT
ADDRESS f,G M�00//000p-0001 /8/�27v/92
Lenders Name CRY TEL NO 7 � 5239 1 -`AMIO:t6
Lender a Address �J-
I certify that I have read this application end stele that the above LiC HSE NO p Q C"CLt9s-
Information Is correct I agree to comply with all County ordmencee
and State Iawa relating to building construction antl hereby autharae
representatives Wpm County to enter upon the above mentioned
property for Ina fiction Poe SEE REVERSE FOR EXPLANATORY LANGUAGE - -
t h
6KiNA R F
DATE
EA�`
-1L R