HomeMy Public PortalAbout4842 ARDEN DR_Mechanical__ v COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0508120003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:., '
TR: 15098 LT: 12 4842 ARDEN DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804001
ASSESSOR INFORMATION NUMBER: ' NEAREST.CROSSw.STREET: LOWER AZUSA..
8585-016-021 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: :597 GRID: BS LOCALITY:,TEMPLE CITY, C
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
30 AIR INLETS/OUTLETS 8.00 UNI 34.80 08/12/05 - VG. 02/08/06
TOTAL FEES 116.55 -
OWNER: TEL. NO: FINAL DAT FgiINNAL BY: CODE:
TAYLOR, ROBERT/LOIS (909) 292-8541-
4642 ARDEN DR -,,
TEMP 917804001 r_5 DESCRIPTIO17MOFAW09141
` - REMOVE WALL HEATER AND INSTALL NEW HVAC
APPLICANT: TEL. NO: -
AAA GRANGER'S AIR CONDITIONING (626) 579-3680-
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS .DATE INSPECTOR SIGNATURE
AAA.GRANGER'S AIR CONDITIONING (626) 579-3680- '
16336 ARROW HWY LIC. NO - _. FAU/WALL FURNACE '-
IRWINDALE, CA 91706 273569C20 -
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
LIC. NO: AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
REPORT ID; DPR264 ROUTE TO: BS0508
WORKER'S COMPENSATION DECLARATION 20-0046 DPW 9/89r
76A364C A�hP:•LICATIO.N FOR PERMIT ' li � ,' GREEN
P hereby affirm:that l have a certificate of consent to self insure, ,.,w,
or a certificate of Worker's Compensation Insurance, or a certified HEATING'.-VENTILATING-AIR CONDITIONING
copy thereof(Sec.3800-Lab.C.)
Policy No. Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV;
Certified copy is hereby furnished.
❑ Certified copy isfiled with the county building inspection FOR APPLICANT TO FILL IN BDDRE S
department. _ ' (PRINT OR TYPE ONLY),,. _
Date Applicant." LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE -
CERTIFICATE OF EXEMPTION 1°ROM'WORKERS' NEAREST
COMPENSATION INSURANCE CROSS,ST.
_ ABSORPTION UNIT,BTU ASSESSOR
(This section need.not•be completed if the work involved by the MAP BOOK PAGE PARCEL
.permit is for one hundred dollars($100)'or-less.). AIR HANDLING UNIT,CFM DlsrRlcr No. PRocesseD BY
I certify that lin the performance of the work for which this permit -
is issued, I shall not employ any person in any manner so as to BOILER,BTU
become subject to the Workers'Compensation Laws.
COMPRESSOR;BTU
-`1 - APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant----- VENTILATION'SYSTEM'
• NOTICE TO APPLICANT: If, after making this Certificate of ROUGH
Exemption,you`should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code; you must forthwith comply with such FINAL =�=
provisions or this permit shall be deemed revoked. - FURNACE: FAU ' ' GRAVITY
LICENSED CONTRACTORS DECLARATION'. FLOOR BTU 'VALIDATION 4.
hereby affirm that I am licensed under provisions.of Chapter 9 SUSPENDED UNIT
(commencing with Section 7000) of Division 3 of the Business and
—EATER—WALL �� S
Professions.Code,,and my license is.in'full force and effect. '
License Number Lic.Class _
Contractor Date
❑ I am'exempt under Sec. Plan-Check fee O
t
B.&P.C.for this reason' PERMIT ISSUING FEE$ O
Dater 3 --' W
TOTAL FEE. a, D
T
Signature , i1
- - 'PLAN CHECK APPLICANT —.
OWNER-BUILDER DECLARATION` ;z', 5 g? F i t f '�
I hereby affirm that I am exempt"from the Contractor's'License Law - NAME
for,the following reason (Section 7031.5,,Business and Professions
:.Cod e)' • .ADDRESS - f•'+.
a 14
I, as owner of the'property; or my employees with wages
as their solecompensation, will do the work and the CITY TEL.NO.
structure isnot intended or offered for sale'(Section 7044,
'Business and Professions Code): +V OWNER
..l
d I, as owner ofJhe property, am exclusively,contracting- em
MAIL �a° �
CJ f _;
with {icensed'contractors to construct the project`(Sec- ADDRESS !
tion 7044, Business and Professions Code). - Q
CONSTRUCTION LENDING AGENCY CITY Ae 'if
TEL.NO. /3
I hereby affirm that there is a construction lending agency for CONTRACTOR' 17
the performance of the work for which this permit is issued �_v •
(Sec.3097,Civ.CJ.
ADDRESS _
Lender's Name
CITY TEL.NO.
Lender's Address STATE LIG
certify that I have read this application and state that the above LICENSE NO. CLASS
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 the above-mentioned
property for inspection purpo S. SEE REVERSE FOR EXPLANATORY LANGUAGE '
gid'NfrREAPPLICA O AGENT DATE V