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HomeMy Public PortalAbout6231 SULTANA AVE_Mechanical__ 76A364C CE-818(REV.11/78) es APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES BUILDING AN94AFETY BUILDFOR APPLICANT TO FILL IN ADOR N (PRINT OR TYPE ONLY) DDRE LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST CROSS ST: t� ABSORPTION UNIT,BTU OWNER AIR HANDLING UN CFM MAIL ADDRESS BOILER,BT CITY COMPRESSOR,BTU CONTRAC VENTILATION SYSTEM ADDRES EVAPORATIVE COOLER CITY r TEL.NO. FURNACE: FAU GRAVITY STATE LIC. FLOOR BTU LICENSE NO. Q CLASS HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE WALL • ROUGH �- FINAL u INSPECTION RECORD cc O Plan check fee 25% of above. m w PERMIT ISSUING FEE$ TOTAL FEE PLAN CHECK APPLICANT PLAN CHECK VALIDATION NAME o Gv. - ADDRESS ��� CITY TEL.NO. U G I HEREBY ACKNOWLEDGE THAT I HAVE READ APPLICATION ANDSTATE G ORDINANCESTHAT TH NDDBOAALL �ISS COGULAT.IA D AG HE IN T VENTILATING.LY IAIR �6 1 Q 8A CONDITIONING. PERMIT VALIDATION # o o'o 0 4 1 I HEREBY CERT THAT M NOT TIN IN VIOLATION,OF CHAPTER 9, DIVISI 3, OF USINES AND ROF SIONAL CODE OF THE STATE OF 2 ­ 27.00 SIGNATURE OF PERMITTE 27,00 DISTRICT NO. CESS BY '57 08, 13-79 WORII�ERS',COMPENSATION DECLARATION 76A364C /� ®®® r hereby,0t1fm khat I hale a' certiRcate of consent to self CE-818(2-80) APPLICATION FOR PERMIT m'surg,or a Frettificate of Workers'Compensation Insurance,or HEATING-V E:NTIL.ATING-AI12 CONDITIONING a cell lacy )ed�clo�yXreof Z�3g0!3 ) P13 olicy o. Company Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY Certif'ed co y is filed with the count bui g inspection BUILDING e a FOR APPLICANT TO FILL IN (hof ate Applicant L (PRINT OR TYPE ONLY) ADDRESS LOCALITY CERTIFICATE OF EXEIAON FROM W RKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE COMPENSATION INSURANCE NEAREST (This section need not be completed if the work involved ABSORPTION UNIT,BTU CROSS ST. O by the permit is for one hundred dollars ($100) or less.) DISTRICT NO.. 67 1 PROCESSED BY V I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM permit is issued, I shall not employ any person in any manner O APPROVALS DATE IN ECs SIGNATURE W so as to become subject to the Workers'Compensation Laws. BOILER,BTU Date Applicant COMPRESSOR,BTU s fO/ �f./� T ' ROUGH t3 N., NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL — Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code,you must forth- EVAPORATIVE COOLER VALID ISN 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 HEATER: SUSPENDED UNIT 9 (commencing with Section 7000)of Division 3 of the Busi- WALL ness and Professions Code, and my license is in full force and J effect. Q -�V/e7'S U e�5 License Numher 99 o• Lic-Class _ S ® � / Contrac �e ;!3 9 2 0 A El I am exempt f om the licensing requirements as I am a licensed architect or a registered professional engineer Plan check fee 25%of above. # a a o o ® 8 acting in my professional capacity (Section '7051, Bus- iness and Professions Code). a SC I e o 4 a o 0 Lic.or Rek.No. Date TOTAL FEE s o 0 4 a p o ux HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT 01.24=86 I hereby affirm that I am exempt from-the Contractor's NAME License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): ADDRESS DI, as owner of the property, will do the work and the CITY TEL.NO. structure is not intended or offered for sale (Section 7044,Business and Professions Code). OWNE OR I, as owner of the property, am exclusively contracting with licensed contractors to construct the project MAIL �7 (Section 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY TEL.N ' 6, I hereby affirm that there is a construction lending agency CONTR OR for the performance of the work for which this permit is issued Sec.3097,Civ.C.). Lender.s Name ADDRESS,.70 3 (✓� ` Lender's Address CITY TEL.NOF.] 3 I certify that I have read this application and state that the STATEs-► Q LIC. _ above information is correct.I agree to comply with all County LICENSE NO. !3 C7� 0 , CLASS O ordinances and State laws regulating Heating, Ventilating and Air Conditioning,and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE County to enter upon the above-mentioned propert for in ct on p rpPs90 - if L12 A'A- &�==e 1 Z/ 'k S' a re of Permitp5e Dat - WORKERS'COMPENSATION DECLARATION CEA386 8C( 2 80) APPLICATION FOR PERMIT I.hereby iffirm that I have a' certificate of consent to self *h sure, or`- 1derttiicate of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING a cgti 'ed copy thereof(Sec.3800, ab. .) Q 8l�-�7- 009(3 Policy o. ompany Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY Ide p ri d co y is filed wit e c unty b ldin`'nspectionTABSORPTION OR APPLICANT TO FILL IN BUILDING - /I par Date Applicant 1. � (PRINT OR TYPE ONLY) ADDRESS LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NOF APPLIANCE OR EQUIPMENT FEE COMPENSATION INSURANCE NEAREST } (This section need not be completed if the work involved UNIT,BTU CROSS.ST. C by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. PROCESSED BY 0 I certify that in the performance of the work for which this ANDLING UNIT,CFM iL permit is issued, I shall not employ any person in any manner 0 so as to become subject to the Workers'Compensation Laws. BOILER,BTU 3� DO� APPROVALS DATE INSP CTOR'SSIGN TUBE w Date Applicant COMPRESSOR,BTU ROUGH W NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL Z Exemption, you should become subject to the Workers' Compensation provisions of the Labor-Code,you must forth- EVAPORATIVE COOLER VALIDATION with comply with such provisions or this permit shall be deemed revoked. I FURNACE: FAUG VITY LICENSED CONTRACTORS DECLARATION FLOOR: BTU I hereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT 9 (commencing with Section 7000) of Division 3 of the Busi- WALL Hess and Professions Code, and my license is in full force and effect. y� =N I TS to T-� /� 0 e- License Number�SLic.Class up5 /, 7s-e, . S Contra ate I am exem from the licensing requirements as I am a licensed architect or a registered professional engineer Plan check fee 25%of above. acting in my profession;capacity (Section 7051, Bus- iness and Professions Code . PERMIT ISSUING FEE$ 9 19 A Lic.or Reg.No. Date TOTAL FEE # o o © 0 0 8 ,HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT e o (j.a,o o I hereby affirm that I am exempt from- the Contractor's NAME License Law for the following reason (Section 7031.5, Busi- o 0 0 448.Q Q 0 ness and Professions Code): ADDRESS ❑ I, as owner of the property, will do the work and the 0 1,2 4=8 6 structure is not intended or offered for sale (Section CITY TEL.NO. 7044, Business and Professions Code). ❑ OWNER ,tom I, as owner of the property, am exclusively contracting with licensed contractors to construct the project MAIL //? 9 / (Section 7044,Business and Professions Code). ADDRESS / CONSTRUCTION LENDING AGENCY CITY TEL.NO� �P6S- I hereby affirm that there is a construction lending agency CONTRA O for the performance of the work for which this permit is issued Sec.3097,Civ.C.). Lender.s Name . ADDRESS 0 3 F, Lender's Address CITY TEL.N I certify that I have read this application and state that the STATE 3 q CLASS d above information is correct.I agree to comply with all County LICENSE NO. ordinances and State laws regulating Heating,Ventilating and Air Conditioning, and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE County to enter up the above-mentione pro rty for ins ti pu ose - • LC Q S' ature dr Permit a Dat