HomeMy Public PortalAbout4835 ARDEN DR_Mechanical__ WOIt{LRS'COMPENS '! ,--,'r is*!: , ,',:.ATION CEA 8 8(2-80) G=\1 P U-" Lam. C AT Q O N FOR R P E II S UVU 0 u
I herehy uffirm that I have a certi,wate or consent to self
insure. or a certificate of Worlce•rs'0;,nh.wsst'.on Insurance,of HEATING-VENTILATING
NTIL.ATING-Apf�t �:®N®pTI®Nplr`�7�
a certifie�dco//py thereof f ec. 360J,Lab.f'.;
Policy;w Z �+ O`'Compan77
C I
El Certified copy is hereby furnished.
COUNTY OF LOS ANGELES BUILDING ARID SAFETY
fied copy is filed with t• county uilding inspection
p FOR APPLICANT TO FILL IN BUILDING '
dep T/rent. ADDRESS ',
Date�/�_ Applicant. _ (PRINT OR TYPE ONLY)
666 LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO, TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPENSATION INSURANCE NEAREST lop
CROSS ST. }
(1,itis sectzon need not be compieted if the work involved ABSORPTION UNIT, BTU 0-
by :.le permit is for one hundred dollars ($1100) Or less.) DISTRICT NO. PROCESSE V 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 �i e cc
so as to become subject to the Workers' Compensation Laws. BOILER, BTU O
APPROVALS DATE INSPECTOR'S SIGNATURE V
Date Applicant COMPRESSOR,BTU ROUGHpW,
NOTICE TO APPLICANT: If, after making this Certificate ofVENTILATION SYSTEM FINAL moo U)
i)
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
LICENSED CONTRACTORS D"CLAR ATION FLOOR: BTU ,/� y6
I hereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT J2-
9 (commencing with Section 7000) of Division 3 of the Busi- ' WALL
ness and Professions Lode, and my license is in full force and = 0 Q
effect. � •ti( f—L r
License Number. C/ S Lic.Class F� �
1
Contract�'Veh_r`t_C'L__ Date___ __8p-
am exempt from the licensing requirements as I am a
Hecnsed 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 $
Lic.ur RLg.No. Date TOTAL FEE S�
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from- the Contractor's NAME
License J.aw for the following reason (Section 7031.5, Busi-
ness and Professions Code): ADDRESS
1, as owner of the property, will do the work and the
structure is not intended_ or offered for sale (Section CITY /y TEL. NO. 2!�6 0 1,8 A
7044, Business and Professions Code).
❑ .
I, as owner of the property, am exclusively contracting OWNER # o•o.o o o 8
with licensed contractors to construct the project MAIL
(Section 7044, Business and Professions Code). ADDRESS � s �!� ��/� 2 0 .0
1 650
CONSTRUCTION LENDING AGENCY CITY e` TEL.NO. 0 0 0 1 -6-50-5
I hereby affirm that there is a construction lending agency —"
for the performance of the work for which this permit is CONTRACTOR I�l�� y- � P ,0'2-8'2
issued (Sec. 3097,Civ.C.). ��JJ��----// �� !! LG(, .
Lender's Name ADDRESS
Lender's Address CITY � ZZY TEL.NO� ,
I certify that I have read this application and state that the STATE CLASS �✓
above inturmation is correct.I agree to comply with all County LICENSE Na.
ordinances and State laws regulating Heating, Ventilating and
Air C..on,' honing, and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter upon the above-mentioned property for
inspec on urp� •s.
Si , >ure of Permittee Dat
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPAR'T'MENT OF PUBLIC WORKS 9701 LAS TUNAS
ME 0508 1003240001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: IFEES PAID I BUILDING ADDRESS: I
ITR: 11148 IT: 5 BL: A 1 1 4835 ARDEN DR I
I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804051 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18585-015-007 101 PERMIT ISSUANCE FEE 27.75 1 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY, Cl
1 141 VENTILATION FAN 2.00 FAN 31.50 1 1
TENANT: i TOTAL FEES 59.25 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
103/24/10 SR 03/24/11 1
I I
1 OWNER: TEL, NO: I I r�CLE FIN���III...��_BY: CODE: 1
1LAN THA DOAN (310) 800-3909- 1 IE 14835 ARDEN DR I �Jvy
(TEMP 917804051 1 (DESCRIPTION OF WORK
1 i 12 VENTILATIONS FANS FOR BATHROOMS REMODEL
1APPLICANT: TEL. NO: 1
IPHD BUILDER INC. (626) 589-2027- 1
110050 GARVEY AVE 101 1 ISPECIAL CONDITIONS: 1
1EL MONTE, CA 91732 1
I I
(CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
IPHD BUILDER INC. (626) 589-2027- 1
110050 GARVEY AVENUE #101 LIC. NO 1 IFAU/WALL FURNACE I1 1
1EL MONTE, CA 91732 868680 B 1
COMBUSTION AIR OPENINGS 1
(ARCHITECT OR ENGINEER: TEL. NO: (DUCT WORK I
I - I
LIC. NO: i 1AC/COMPRESSOR 1
I I I
_i (THERMOSTAT 1 1 1
1 i IFIRE DAMPERS 1 1 1
(SMOKE DETECTION DEVICES
I (COMMERCIAL HOOD 1 1 1
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1
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REPORT ID: DPR264 ROUTE TO: BSO508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1004270001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 11148 LT: 5 BL: A 1 4835 ARDEN DR
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917804051
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18585-015-007 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: BS LOCALITY: TEMPLE CITY, Cl
1 102 COMPRSR < 100 KBTU 1.00 COM 27.00 I 1
(TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: I
130 AIR INLETS/OUTLETS 8.00 UNI 34.80 104/27/10 SR 1
1 I TOTAL FEES 116.55 1 I
I OWNER: TEL. NO: IPN%DATE� FINAL BY: CODE
(LAN THA DOAN (310) 800-3909- I I ///k)]'►I�/)
14835 ARDEN DR 1 { I
ITEMP 917804051 1 I ESC IPTION OF WORK 1
I 1 (INSTALL AIR CONDITIONING AND HEATING SYSTEM I
(APPLICANT: TEL. NO: 1 I I
IPHD BUILDER INC. (626) 589-2027- 1 I I
110050 GARVEY AVE 101 1 ISPECIAL CONDITIONS: 1
1EL MONTE CA 91732 1 1 1
ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
IPHD BUILDER INC. (626) 589-2027- 1 1 I
110050 GARVEY AVENUE #101 LIC. NO 1 1FAU/WALL FURNACE / 1
1EL MONTE, CA 91732 868680 B I I I I
1 I ICOMBUSTION AIR OPENINGS 1 I I
1ARCHITECT OR ENGINEER: TEL. NO: 1 IDUCT WORK I I
1 LIC. NO: I 1AC/COMPRESSOR 1 I 1
I I ITHERMOSTAT I 1
1 I IFIRE DAMPERS I I I
1 I ISMOKE DETECTION DEVICES I 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 I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
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1 (REPORT ID: DPR264 ROUTE TO: BS0508 1 1 I 1
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