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Home My Public Portal About5125 BALDWIN AVE_Mechanical__ 20 0046 WORKER I haveCOMPENSATION ate of consent to 76A364 DPW 9/89 APPLICATION FOR'PERMIT LIME GREEN � 76A364C I hereby aff jm that I have a certificate of consent to self Insure or a certifwate+of Worker s Compensation Insurance or a certified� HEATING VENTILATING-AIR CONDITIONING copy thereof(Sec 3800 Lab Cg) { Policy No 0 _ 41pany S�li COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV LL Certified copy Is hereby furnished ❑ Certified copy Is filed with the county iii m inspection FOR APPLICANT TO FILL IN BUILDING, departure t p (PRINT OR TYPE ONLY) ADDRESS �IfZ}�P'{�IZ,C� Date ? Applicant NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY NEAREST CERTIFICATE OF EXEMPTION FR M WORKERS CROSS ST COMPENSATION INSURANCE ABSORPTION UNIT BTU ASSESSOR pp' p �y (This section need not be completed if the work involved by the MAP BOOK p�0 PAGE � PARCEk!91f permit is for one hundred dollars($100)or less)�_ LING UNIT CFM DISTRICT NO PROCESSED BY I certify that In the performance of the work for which this permit Issued I shall not employ any person in any manner so as to b BOILER BTU become subject to the Workers Compensation 'i.on Laws 000 , COMPRESSOR BTU 3G '0 Date Applicant APPROVALS d DATE INSPECTOR S SIGNATURE . d� NOTICE TO APPLICANT If after making this Certificate of ROUGH Exemption you'should become subject to the Workers Compensation EVAPORATIVE COOLER lk provisions of the Labor Code you must forthwith comply with such FINAL provisions or this permit shall be deemed revoked ♦ FURNACE FAU GRAVITY j LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED—UNIT— (.o USPENDED UNIT - (commencing with Section 7000) of Division 3 of the Business and HEATER WALL Professions Code and my license is in full force and effect IIrre License Number Llc Class t , � Contractor M 1 x A i M&P— O Date V F-1I am exempt under Sec ` Plan check fee - Q B&P C for this reason PERMIT ISSUING FEE U A Date TOTAL FEE ACCT Signature } - :� � 110.J5 OWNER BUILDER DECLARATION PLAN CHECK APPLICANT �- Z T I hereby affirm that I am exempt from the Contractors License Law NAME 1 ITEMS`s for the following reason (Section 7031 5 Business and Professions )t - - ► 1 Ti IT -!.9•"O cii=, ❑Code) ADDRESS L1 U I as owner of the property or my employees with wages ry� CHE:K 11G.cc as their sole compensation will do the work and the CITY ^ � TEL NO ■ fl structure is not intended or offered for sale (Section 7044 l ` CHANGE r Business and Professions Code) OWNER ❑ I as owner of the property am exclusively contracting I s MAIL rr''�yC�ryy-- with licensed contractors to construct the project (Sec ADDRESS + —E3VU1 j�� ' tion 7044 Business and Professions Code) wM CONSTRUCTION LENDING AGENCY CITY TEL NO - 9919 1 A `11•,tq I herebypperformance affirm that there is a constructions perm agency for IA q+f �S� 71 Y +�1 n the erformance of the work for which this permit Is issued CONTRACTOR (Sec 3097 Civ C) 1 ADDRESS Lender s Name , CITY Y ^ AL NO Lender s Address " STATE CLASS I t f t LIC I certify that I have read this application and state that the above LICENSE NO Information,is correct I agree to comply with all County ordinances + - and State laws relating to budding construction and hereby authorize " rep resentatsof this County to enter upon the above mentioned " property f r nspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE - - - A�nn� - - 3 SIGNATUREVF APPLICANT OR AGENT DATE —T t WORKERS COMPENSATION DECLARATy1 ~+ C 'g18 (2 80) If— I!� lS_QHS�� ®0�1 FOR If� L�U`6 d�U �� I hereby affirm that I have a certificate of Ponsent to self insure or a certificate of Workers Compensation Insurance or HEATING-VENTILATING-AIR CONDITIONING a cer fed copy thereof(Sec 3800 Lab C) PohcGT�c� ?h7p7a7�- -d—tx COUNTY OF LOS ANGELES BUILDING AND SAFETY 0 Certified copy is hereby furnished ertified copy is filed with the c my building inspection FOR APPLICANT TO FILL IN BUILDING department Date 2 ��licant (PRINT OR TYPE ONLY) ADDRESS _ 7 CERTIFICATE OF EXEMPTION FROM WORKERS NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY COMPENSATION INSURANCE NEAREST CROSS ST O}. (This section need not be completed if the work involved ABSORPTION UNIT BTU L,4 OS O by the permit is for one hundred dollars ($100) or less) DISTRICT NO PROCESSED BY U I certify that in the performance of the work for which this AIR HANDLING UNIT CFM I permit is issued I shall not employ any person in any manner �i 0� O so as to become subject to the Workers Compensation Laws BOILER BTU f" , � �c APPROVALS DATE INSPECTOR S SIGNATURE U ` Date Applicant COMPRESSOR BTU —�+erlj-- ROUGH N NOTICE TO APPLICANT If a ter making this Certificate of VENTILATION SYSTEM FINAL �� 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 lw000' GJRAVITY " LICENSED CONTRACTORS DECLARATION FLOOR — BTU_ 66XO ! 6 _ �� r I hereby affirm that I am licensed under provisions of Chapter HEATER SUSPENDED UNIT �F�/J 9 (commencing with Section 7000)of Division 3 of the Busi WALL ness and Professions Code and my license is in full force and Q effect License Number�l + `f�Lic Class- Contract to Z— i am exempt from the licensing requirements as I am a ;241 7 5 A licensed architect or a registered professional engineer Plan check fee 25%of above acting in my professional capacity (Section 7051 Bus # 0'0 0 0 4 1 mess and Professions Code) - PERMIT ISSUING FEE $ Lic or Reg No ate TOTAL FEE HOME OWNER BUILDER DE L R ION PLAN CHECK APPLICANT 2 ° o 2 7 0 0 7 I hereby affirm that I am exempt from the Contractors NAME ° ° ° 2 7 0 0 6 License Law for the following reason (Section 7031 5 Bust r ness and Professions Code) ADDRESS o 22'4-8 1 I as owner of the property will do the work and the CITY TEL NO structure is not intended or offered for sale (Section 7044 Business and Professions Code) , e aOWNER I as owner of the property am exclusively contracting with licensed contractors to construct the project MAIL (Section 7044 Business and Professions Code) ADDRESS CONSTRUCTION LENDING AGENCY CITY TEL NO YC[(4 —Z'ZJ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is CONTRACTOR issued (Sec 3097 Civ C) — Lender s Name_ ADDRESS ///�� Lender s Address ` 4 CITY (9 TEL NOS I,1 f_ (_—i(i_ i certify that I have read this application and state that the STATE LIC L=�C� above information is correct I agree to comply with all County LICENSE NO 1 CLASS ordmanc and State laws regulating Heating Ventilating and ` Air Co dit nmg and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE Cou y t enter upon above mentioned property for ins ection purposes _ 2�y S ure o Permittee Date x I ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0304070002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 9481 LT 1 5125 BALDWIN AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803902 ASSESSOR OR A NEAREST CROSS STREET X0fffflr%l*V/LA ROSA 8589 007 001 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID 64 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 TOTAL FEES 81 75 04/07/03 JK 10/04/03 OWNER TEL NO FINAL DATE FINAL BY COD SCHRANS,THOMAS /f / 5125 BALDWIN AV TEMP 917803902 DESCRIP1 IONF C/O AIR CONDITIONING & HEATING APPLICANT RS AIR CONDITIONING INC (626) 914 4408- 718 E ROUTE 66 SPECIAL CONDITIONS GLENDORA - CONTRACTOR TEL NO %% �� _ �� APPROVALS DATE INSPECTOR SIGNATURE R S AIR CONDITIONING AND HEATING (626) 914 4408 L FURNACE 718 E ROUTE 66 LIC NO GLENDORA, CA 91740 662914 COMBUSTION AIR OPENINGS ARCHITECT R ENGINEER 0 �� / '� , DUCTWORK LIC NO I �� ` _ - �� AC/COMPRESSOR HES FIRE DAMPERS SMOKE DETECTIOW7C S COMMERCIAL HOOD v�L * ADDITIONAL DATA ON FILE REPORT ID DPR264 ROUTE TO SS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1106070009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 9481 LT 1 1 1 5125 BALDWIN AV 1 I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803902 (ASSESSOR INFORMATION NUMBER I I I NEAREST CROSS STREET 1 18589 007 001 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY Cl 1 141 VENTILATION FAN 1 00 FAN 15 80 1 1 TENANT i TOTAL FEES 43 60 (ISSUED ON PROCESSED BY PLAN BY 106/07/11 SR (OWNER TEL NO IFINAL DATE FINAL BY CODE ISTHOMAS (626) 443 4808 15125 BALDWIN AV 1m� l ITEMP 917803902 IDbSIPTIO N OF WORK I REPLACE ONE VENTILATION FAN 1APPLICANT TEL NO IRAZ ARINBAUM (818) 448 1355 I 14759 KESTER AVE I ISPECIAL CONDITIONS 1 1SHER14AN OAKS 1 � 1 I I ICONTRACTOR TEL NO 1APPROVALS DATE INSPECTOR SIGNATURE 1 1UNIVERSAL REMODELING (888) 343 9111 1 1 1 1545 WEST AVENUE 26 SUITE 201 LIC NO FAU/WALL FURNACE ILOS ANGELES CA 90065 617830/2 1 1 1 1 I i 1COMBU,TION AIR OPENINGS 1 1 1 1ARCHITECT OR ENGINEER TEL NO 1 IDUCT WORK 1 1 1 I I LIC NO IAC/COMPRESSOR I iTHERMOSTAT I FIRE DAMPERS 1 1SMOKE DETECTION DEVICES 1 1 1 I I I I I I COMMERCIAL HOOD I I I I I 1 I I I I I 1 I I I I I 1 I I I I I I I I I I II I I I I I I 1* ADDITIONAL DATA ON FILE I I I I I 1 IREPORT ID DPR264 ROUTE TO BS0508 I 1 1 I I I I I