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Home My Public Portal About6050 AGNES AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL,PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9809110001 / ,BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (818) 285 0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 6561 LT 54 N 6050 AGNES AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801707 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET GARIBALDI 5385 028 025 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A2 LOCALITY TEMPLE CITY 02 COMPRSR < 100 KBTU 1 00 COM 27 00 TENANT TOTAL FEES 54 75 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 09/11/98 UT 09/1)/99 OWNER TEL NO FINAL DATEFINAL BY CODE SMITH ROBERT B,MILDRED L TRS ' 6050 AGNES AV TEMP 917801707 -DETEUPTION OF WORK CHANGE OUT OF A/C CONDENSER ONLY APPLICANT NO MIKE DIAMOND (310) 253 5229 3801 LENAWEE AVE SPECIAL CONDITIONS CULVER CITY, CA GELES Co ' CONTRACTOR TEL NO 0� ��/,. APPROVALS DATE INSPECTOR SIGNATURE MIKE DIAMOND PLUMBING AND HEATING (310) 838 0408 3801 LENAWEE AVE LIC NO FX97ULL FURNACE CULVER CITY CA 90232 399170 C36 COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER DUCTWORK LIC NO 1111111 AC/COMPRESSOR THERMCSTAT i �P-'UO L C W0�[� FIRE CAMPERS u� SMOKE DETECTION �j COMMERCIAL HOOD O 0 ❑ ® ®y 4�Z/c S0 �pvae � r r DEPORT ID DPR264 ROUTE TO BS05O8 i 11KERS COMPENSATION DECLARATION APPLICATION FOR PERMIT I he ebym that I have a certificate of consent to self insuror acertie orl eop�aterof Wo(Srkeec s Compe Labnssation Insurance 76A364C HEATING VENTILATING AIR CONDITIONING P t <3 7 / J CE 818(REV 10/81) f Policy No I s�ompany Re 42LA to l G ertified copy is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY ertlfled copy is filed with the county building inspec FOR APPLICANT TO FILL IN BUILDING tion department //I-' ADDRESS e S Ir,4 A (PRINT OR TYPE ONLY) All Date Applicant tLOCALITY _ r 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 PROCESSED BIA ,the permit is for one hundred dollars(;100)or less ) AIR HANDLING UNIT CFM 5, V 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 BOILER BTU APPROVALS DATE INSPECTO SIGNATURE COMPRESSOR BTU UQ ROUGH Z/ Date Applicant NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM FINALS`- ' Exemption you should become subject to the Workers Compensation provisions of the Labor Code you must forth EVAPORATIVE COOLER VALIDAT N with comply with such provisions or this permit shall be deemed revoked FURNACE FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU e�0 M , 1 qu I hereby affirm that I am licensed under provisions of Chapter 9SUSPENDED—UNIT— (commencing USPENDED UNIT(commencing with Section 7000) of Division 3 of the Business HEATER WALL and Professions Code and my license is to full force and effect } d. License Number �7 l0 7 �o LIc Class �'z fl , V Contractor a n !Lktes ate 0 P O � 17Q5,A ~ ❑ I am exempt under Sec y uVi Plan check fee # 0 0 0 0 • $ vii B 8P C for this reason Date PERMIT ISSUING FEES Q Z TOTAL FEE Q SD I o � `�Q 5� Signature OWNER BUILDER DECLARATION PLAN CHECK APPLICANT • • e 3 Q 5 0 53 I hereby affirm that I am exempt from the Contractor s License , 0 3 1 $t$5 Law for the following reason (Section 7031 5 Business and NAME Professions Code) ❑ 1 as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and the structure Is not intended or offered for sale(Section CITY TEL NO s 7044 Business and Professions Code) OWNER ❑ I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec MAIL tion 7044 Business and Professions Code) ADDRESS e CONSTRUCTION LENDING AGENCY CITYTEL NO'S I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CONTRACTOR r - (Sec 3097 Civ C ) ADDRESS - r Lender s Name \ CITY j> C. _/� TEL NO _ O Lender s Address C� STATELIC I certify that I have read this application and state that the LICENSE NO _7- a CLASS (:-2- 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 thebove aentioned property for inspection purposes/ SEE REVERSE FOR EXPLANATORY LANGUAGE g Signature of Applicant or Agent Dote ' 5 f