The URL can be used to link to this page

Home My Public Portal About10535 FREER ST_MECHANICAL_6/12/2017_TEMPLE CITY PERMIT NO. M17-34364 City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us Address: 10535 Freer Street, Temple City, Parcel: 8585-021-034 Inlet/Outlet California 91780 Commercial Qty Permit No: M17-34364 Type: Mechanical Subtype: Subtype: Residential Description: 4 TON AM CHANGE OUT- SAME Special CFM LOCATION COIL Conditions: Fire Damper 0 Issue Date: 06-12-2017 Expire Date: 12-09-2017 Extension: Extension: Permit expires on date shown If: 1) work does not commence, or 2) work Is suspended or abandoned, or 3) applicant falls to obtain code required inspection. Contacts Owner Carlos Iberri Applicant Meirav Eisenberg Contractor C:1,alaeical Details Compressor/Furnace 1 /Etc up to IOOk BTU Appliance Vent 0 Ventilation Fan 0 Fireplace 0 Service Champions Inc DBA Service Champions Heating and Air Conditioning Compressor/Furnace 0 /Etc 100-500k BTU Air Handler up to 0 2,000 CFM Ventilation System 0 10535 Freer Street, Temple City, California 91780 31225 La Bays Drive, Westlake Village, California 91362 3150 East Birch Street, Brea, California 92821 (626)444-7021 (818)732-7876 (714) 777-7777 799170 Compressor/Furnace 0 Air 0 OR Floor 0 /Etc over SOOk BTU Inlet/Outlet Area Commercial Qty Hood Air Handler 2-10,000 0 Air Handler 0 Evaporative 0 CFM over 10,000 Cooler CFM Kitchen Hood/Spray 0 Fire Damper 0 Duct 0 Booth Alteration Plan Check Fees $113.60 Permit Fees $34.29 Mechanical Inspections Approval Date Inspector Approval • t pe FAU/Wall AC/Compressor Furnace Thermostat Combustion Fire Dampers Air Openings Duct Work Approval Date Inspector Smoke _ Detectors Commercial Hood FINAL ti `O v 1 ,W CA m m OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) Indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 1, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the Owner - Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). U I am exemdt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priorl to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: ham://www.leoinfo.ce.aov/calaw.html//www.leoinfo.ce.aov/calaw.html. Date: Signature of Property Owner or Authorized Agent 411=34SIleril1:7_T3]Eel :i _ 1�4351.7-1106171 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. p License Class C 2_� License No. Date /67ontractor Signature WORKERS' COMPENSATIO EC TION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. P tic I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is 'as ed. My wo ers' comp W e ation insur7n carrierJJ nd nu er a ri-�7 Z2— C rrie PoINumber.Ex iratio Date : 7� ,may— Name of Agent Phone Number _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Signature of Applicant Date LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits in Unincorporated Los Angeles County only This is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue to complytherewith through the application process. l'oh/ Applicant (Print N me) ' Appli�Sign rere ��vl� /Z Company Name /e� Date JOB ADDRESS LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than the amount specified on the hazardous materials information guide? Yes ❑ N o ❑ Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes ❑ No ❑ I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirements under the Los Angeles County Code Title 2, Chapter 220 Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbestos removal is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address ' By my signature below, I certify to,each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this county to enter the above -identified property for inspection purposes. Signature of P_mpogVner or Authorized Agent Date Co // Z // ;I—