HomeMy Public PortalAbout5406 BALDWIN AVE_Mechanical__ (3) COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0003100006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEESBUILDING ADDRESS
ON FILE 5406 BALDWIN AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 91780
ASSESSOR N 0 MATIO R NEAREST CROSS STREET OLIVE
8586 023 023 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY
02 COMPRSR < 100 KBTU 2 00 COM 54 00
TENANT TOTAL FEES 81 75 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
03/10/00 UT 09/06/00
OWNER TEL NO FINAL DATE FINAL BY CODE
GLESBY ROSE F
631 PARKROSE AV Zwo
MROV 910163770 D��TPT I ON O
UPGRADE 2 REFRIGERATION UNITS (COMPLETE SYSTEMS)
APPLICANT TEL NO
PHILS COMMERCIAL REFRIGERATION (562) 802 1629
15641 LEMON DR SPECIAL CONDITIONS
WHITTIER CA
ES CTEL
® A�
PHILSACTOR COMMERCIAL REFRIGERATION (562)N802 1629 ®� ��1A9- APPROVALS DATE INSPECTOR SIGNATURE
15641 LEMON DR LIC NO FURNACE
WHITTIER CA 219077 C38
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER TEL NO / DUCT WORK
LIC NO I 1111117 AC/COMPRESSOR 1�Z
lU THERMOSTAT T
Ilrr--(�)� D L�� � /, f7O(_^,n/7 FIRE DAMPERS
IIJ� \VI]�1\JIl pLJ��<{�LJ�(� SMOKE DETECTION DEVICES /
COMMERCIAL HOOD
C/ ❑ ** _
❑ ® ®y
48�le SLrv0e'1a{���oi
REPORT ID DPR264 ROUTE TO BS0508
WORKERS COMPENSATION DECLARATION CEA 8 8C(2 80) 6. l.i/"i� ®1\7 ®� PERMIT
I hereby affil— that I have a certificate of consent to self
insure or a certificate of Workers Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING
a certified copy thereofSey 3800 L b
NoC)
Policy -" : ompany
Certified FI COUNTY OF LOS ANGELES T ' BUILDING AND SAFETY
by is he eby furnished '
Certified copy is filed with the count) build g inspection BUILDING
pa tme t" 7 t FOR APPLICANT TO FILL IN ADDRESS t
Date �� l�✓�'cant_ _C_[" C �`r (PRINT OR TYPE ONLY) h
LOCALITY
CERTIFICATE OF EXEMPTION FROh WORKERS NO TYPE OF APPLIANCE OR EQUIPMENT FEE 'P
COMPENSATION INSURANCE * NEAREST
(This section need not be completed if the work involved ABSORPTION UNIT BTU CROSS ST
ZZ
by the permit is for one hundred dollars (5100) or less) DISTRICT NO PROC D U
1 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 r
so as to become subject to the Workers Compensation Laws IBOILER BTU O
APPROVALS DATE INSPECTOR S SIGNAT E V
Date Applicant COMPRESSOR BTU _ ROUGH d
\NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM CL
Exemption you should become subject to the Workers FINAL r Z
Compensation provisions of the Labor Code you must forth EVAPORATIVE COOLER ro VALIDATION '
with comply with such provisions or this permit shall be
deemed revoked
LIC.ENSEDCONTRACTORSDECLARATION / FURNACE FA GRAVITY
FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter HEATER SUSPENDED U IT
9 (commencing with Section 7000)of Division 3 of the Busi WALL
ness and Professions Code and my license is in full force and
effect
License Number ip,t-
74k L,i (''lass d
Contract ��! •��fT Dat
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 capaci" (Section 7051 Bus
iness and Professions Code) PERMIT ISSUING FEE$
Lic or Reg No Date ITOTAL FEE
HOME OWNER BUILDER DECLARATION PLAN CHECK APPLICANT
r
I hereby affirm that I am exempt from the Contractors NAME t
License Law for the following reason (Section 7031 5 Busi
ness and Professions Code) ADDRESS A
I as owner of the property will do the work and the CITY TEL NO ;2,3 3 0 4 A
structure is not intended or offered for sale (Section
7044 Business and Professions Code) �j i# opo)o 0 0 8
OOWNER
I as owner of the property am exclusively contracting
with licensed contractors to construct the project MAIL �-f 1 2 °�O 4 R 5 0
(Section 7044 Business and Professions Code) ADDRESS _ _,W p
CONSTRUCTION LENDING AGENCY CITY �( TEL NO
° a50
I herebv affirm that there is a construe ton tending agency i 0 lib—8 2
for the performance of the work for which this permit is CONTRACTOR 6 ? t � f
issued(Sec 3097 Civ C) -�f f'
Lender s Name ADDRESS ` E `
Lender s Address �
CITY `� /4 c/jr TEL NO _
I certify that I have read this application and state that the STATE LIC
above information is correct I agree to comply with all County LICENSE NO" CLASS
ordinances and State laws regulating Heating Ventilating and
,kir Conditioning and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter upon the above mentioned properly for
inspect; n p ores
Signa ure 0
f Pe nittee / A Dat