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HomeMy Public PortalAbout4948 BALDWIN AVE_Mechanical__ 1 79A394E cE+e5ee 9/715 APPLICATION FOR PERMIT {� HEATING - VENTILATING - AIR CONDITIONING u k 4 BUILDING D SAFETY DIVISIO - FOR APPLICANT TO FILL IN (PRINT OR TYPE ONLY) Ao�REss 4948 Baldwin Avenue ` i. LOCALITY Temple City No TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST < CROSS ST ABSORPTION UNIT BTU OWNER Mrs. Sue Anderson AIR HANDLING UNIT CFM MAIL ADDRESS 4948 Baldwin BOILER BTU CITYTwmple City TEL NO 444-0714 COMPRESSOR BTU 4-ton 7150 CONTRACTOR Bryant Heat. & Air Cond VENTILATION SYSTEM ADDRESS 1350 E. Las Tunas Drive EVAPORATIVE COOLER CITY San Gabriel TEL NO 286-1141 1 FURNACE FAUX' GlRff� 11 25 STATE LICENSE NO 221751 LI SS C20 FLOOR BTU 11 LL ����//�� HEATER SUSPENDED UNIT_ DISTRICT NO GROUP ZONE PR ESSED BY WALL a- �0 `� O INSPECTION RECORD C� v W a N Y Plan check fee 25% of above PERMIT ISSUING FEE S 4 50 TOTAL FEE 23,25 PLAN CHECK APPLICANT NAME ADDRESS LCI TY TEL NO ' I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIT HALL ORDINANCES AND LAWS REGULATING HEATING VENTI LAT ING AIR CONDI&LFORNIA I HEREBY CERM NOT ACTING ATION APPROVALS DATE INSPECTOR S SIGNATURE OF CHAPTER 9 DIBUSINESS AND PRO SIGNAL OUGH CODE OF THE STAT SIGNATUREm-OF PERMITTEE -FINAL 1 PLAN CHECK VALIDATION PERMIT VALIDATION cK M o cnsH LK M 0 CASH 176-r-AUG 124. 1 D 2 3.2 5 `/ WORKERS'COMPENSATION DECLARATI(;N �, _11i 8(2-80) °. P p UC QT�O N FOR P C R MT I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,o'r a certified copy thereof(Sec. 3800,Lab.C.) Policy No. Company Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUB L00NG AND SA FfETY Certified copy is filed with the county building inspection department. FOR RPPMANT TO FOLL INBUILDING ` �� Date Applicant (PRINT OR TYPE ONLY) ADDRESS /d ,fly LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE COMPENSATION INSURANCE NEAREST � �N�S a (This section need not be completed if the work involved ABSORPTION UNIT, BTU CROSS ST. by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. -- PROCESSrD BY 0 I certify that in the performance of the work for hich this AIR HANDLING UNIT,CFMCC permit is issued, I shall not em any person i y manner — © O so as t�TAP�PL omsubject tot Wor er jd om anon .aws. BOILER, F- APPROVALS DATE INSPECTOR'S INSPECTOR'SSIGNATURE W DaterACn pplicant �!/��L'� G Y r can I u ROUGH �C./`.� °" CLNOTI ICANT: If, after making this Certificate of VENTILATION SYSTEM z Exemption, you should become subject to the Workers' FINAL 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 DECLARATION I hereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT 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 Lic.Class 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). PERM5T 9SSUING 'FEE $ Lic.or Reg.No. Date E _ HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from- the Contractor's 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 structure is not intended or offered for sale (Section CITY TEL. NO. 04029A - 7044, 4029A '7044, Business and Professions Code). QOWNER _Z ` d S � I, as owner of the property, am exclusively contracting u A� ikee / # ° °I® ° 141 with licensed contractors to construct the project MAIL �/ o (Section 7044, Business and Professions Code). ADDRESS AyldQ d/A/ 2 s° ° 1 3.00 T CITY re, j TEL. NO.�/[//L1�7/ 7/ s CONSTRUCTION LENDING AGENCY 1 3.006 I hereby affirm that there is a construction lending agency CONTRACTOR for the performance of the work for which this permit is 2 11',0 8'1 issued(Sec. 3097,e, . y/� Lender's Name /+'I�o� _/��r/CAS� ADDRESS Lender's Address_-_B/cf/''fi?lr�B,l�so ZJ/NNfIt CITY J• /1 1 certify that I have read this applicatiG� and state STATE LIC. above inforfnation is correct. I agree to comply with all County LICENSE NO. CLASS ordinances and State laws regulating'Heating, Ventilating and Air Co itioning, and he y authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE Co ty o e ter up Ie ab ve mentioned prope ty for ill, ti n p ores. ignature of Pe tt Date