HomeMy Public PortalAbout5120 BALDWIN AVE_Mechanical__ (2) COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1401080009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
ILEGAL ID FEES PAID
I BUILDING ADDRESS 1
ITR 10821 LT 1 BL 001 I 1 5120 BALDWIN AV 1
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803901 1
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1
18585 007 001 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY CAI
I 130 AIR INLETS/OUTLETS 2 00 UNI 8 80 I 1
1TENANT 141 VENTILATION FAN 1 00 FAN 15 80 (ISSUED ON PROCESSED BY PLAN BY 1
147 ALTER EXIST DUCT SYS 1 00 SYS 27 00 101/08/14 SR 1
1 I TOTAL FEES 79 40 1 1
1OWNER TEL NO I IF NAL DATE FI4AL BY CODE
1FLORENCIA PILPA I
15120 BALDWIN AVE
1
1TEMPLE CITY CA 91780 1 JD'ffsck-iPttoA OF WORK 1
I (ALTERATION OF EXIST DUCT SYSTEM VENTILATION FAN AND 2 AIR 1
1 (INLETS 1
1APPLICANT TEL NO 1
1KATIGBAK MAGNO (909) 267 8749 I
1
1961 CALLE HERMOSA
1SPECIAL CONDITIONS 1
SAN DIMAS CA 91773 1
II
1 1 1 I
ICONTRACTOR TEL NO 1
I (APPROVALS DATE INSPECTOR SIGNATURE I
IM S K BUILDERS (909) 267 8749 I
1961 CALLE HERMOSA LIC NO I IFAU/WALL FURNACE I I 1
ISAN DIMAS CA 91773 720840 * 1 1 1 1
COMBUSTION AIR OPENINGS 1
1ARCHITECT OR ENGINEER TEL NO IDUCT WORK
1MENOR PETER (323) 255 3934 1 1y
11511 OAK GROVE DRIVE LIC NO
ILOS ANGELES CA 90041 C28539 I IAC/COMPRESSOR
I
ITHERMOSTAT I 1
1FTRE DAMPERS I I 1
SMOKE DETECTION DEVICES I I
ICOMMERCIAL HOOD
I
1 I I I I I
I I I I
I I I I I I
I I I I
I 1
1* ADDITIONAL DATA ON FILE I 1 1
I 1
REPORT ID DPR264 ROUTE TO BS0508 I I 1
I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 9907280006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 10821 LT 1 BL 001 5120 BALDWIN AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803901
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
8585 007 001 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY
02 COMPRSR < 100 KBTU 1 00 COM 27 00
TENANT 08 FURNACE/HEATER <100 1 00 UNI 27 00 ISSUED ON PROCESSED BY PLANBY EXPIRES 0
30 AIR INLETS/OUTLETS 15 00 UNI 65 25 07/28/99 UT 01/24/00
TOTAL FEES 147 00
OWNER TEL NO FINAL DAT N BY
PILPA,FLORENCIA I ( -�
5120 BALDWIN AVE
TEMPLE CITY CA MUM ION OF WORK
NEW HEATING AND COOLING SYSTEM FOR IDENCE
APPLICANT
M S K BUILDERS (909) 592 3465
129 W THIRD ST SPECIAL CONDITIONS
SAN DIMAS CA
CONTRACTOR TEL NO ��J APPROVALS DATE INSPECTOR SIGNATURE
M S K BUILDERS (909) 592 3465 y ,9►
129 WEST THIRD STREET LIC NO AC
SAN DIMAS, CA 91773 720840 B
/ COMBUSTION AIR OPENINGS
ARCHITECTOR E 0 DUCT WORK
LIC NO 1111111AC/COMPRESSOR
LTRrRRMTAT
U
2 L�C W G�KS I DAMPERS
6 COMMERCIAL
O
El UP}
,o 0 ® ®y
REPORT ID DPR264 ROUTE TO BS0508
WORKERS COMPENSATION DECLARATION CEA 818(2 80) A P P� C AT U®N FOR P E R� T
I hereby affirm that I have a certificate of consentFto self t ,
insure or a certificate of Workers Compensation Insurance or ( HEATING VENTILATING-AIR CONDITIONING
a certified copy thereof(Sec 3800 Lab C) - 'fl
Policy No Company_�y DUJ_/a/!�X___ 9 4
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy is hereby furnished
fi }
Certified copy is filed with t county building inspection FOR APPLICANT TO FILL IN BUILDING
departmenttf �/ ADDRESS S12-0 )S)4/- •/A/
Date��2- SSI Applicant � �/� (PRINT OR TYPE ONLY) i
LOCALITY I G
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WORKERS /
COMPENSATION INSURANCE a NEAREST , ^ }
(This section need not be completed if the work Involved ABSORPTION UNIT BTU CROSS S4.T 1-0 fA��2 >Z�1 Z /►7 O
by the permit is for one hundred dollars ($100) or less) I DISTRICT NO PROCESSED BY 0
I certify that in the performance of the work for which this AIR HANDLING UNIT CFM V cc
permit is issued I shall not employ any person in any manner ✓C, U O
so as to become subject to the 'orkers Compensation Laws BOILER BTU (-
,�3� .., APPROVALS DATE INSPECTOR S SIGNATURE n W
Date=Z2� Applicant _ ��7 / COMPRESSOR BTU ROUGH J( :$�� 0-
NOTICL TO APPLICANT If after making this Certificate of VENTILATION SYSTEM FINAL Q — --�-��.- 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 - - FURNACE FAU GRAVITY
LICFNSED CONTRACTORS DECLARATION FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter HEATER S DED UNIT Up
9 (commencing with Section 7000) of Division 3 of the Busi C LL
ness and Professions Code and my license is in full force and
effect <
License Number Lie Class e
Contractor Date
I am exempt from the licensing requirements as I am a }
licensed architect or a registered professional engineer Plan check fee 25%of above
acting in my professional capacity (Section 7051 Bus
iness and Professions Code) PERMIT ISSUING FEE $
Lie or Reg No Date TOTAL FEE 111,90
HOME OWNER BUILDER DECLARATION PLAN CHECK APPLICANT R
I hereby affirm that I am exempt from the Contractors NAME
License Law for the following reason (Section 7031 5 Busi
ness and Professions Code) ADDRESS
I as owner of the property will do the work and the CITY TEL NO
structure is not intended or offered for sale (SectionY
7044 Business and Professions Code)
� TM C I as owner of the property am exclusively contracting OWNER 2 1 2 7 9 A
with licensed, contractpts to construct the project MAIL '�
(Section 7044 Business and Professions Code) ADDRESS # o 0Y0 s o 8
CONSTRUCTION LENDINGAGENCYCITY r TEL NO 2 oi° 1 7 O O�
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is CONTRACTOR
issuedSec 3097 Civ C) 1O ° o 1 7 O O v
Lender s Name ADDRESS
` 0922-8+1
Lender s Address CITY TEL NO
d j
1 certify that I have read this application and state that the STATE LIC
above information is correct I agree to comply with all County 11 LICENSE NO CLASS
ordinances and State laws regulating Heating Ventilating and
Air Conditioning and hereby authorize representatives of this I SEE REVERSE EOR EXPLANATORY LANGUAGE
Coun y to enter upon the above mentioned properly for
msp ,ion purposes e
_ _ ty�/ 9—2 Z—�I w
ignah a of Permittee Date
,