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Home My Public Portal About6019 BALDWIN AVE_Mechanical__ 76A384E- CE5183-9i75 APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN BUILDING (PRINT OR TYPE ONLY) ADDRESS 6019 N. Baldwin .4..,— LOCALITY Temple Cit No. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEAREST CROSS ST. ABSORPTION UNIT, BTU OWNER First Baptist Church of T. C. AIR HANDLING UNIT, CFM MAIL ADDRESS 6019 N. Baldwin BOILER, BTU CITY Temple City TEL. No. 286-3125 4 COMPRESSOR, BTU 5-toll 30 00 CONTRACTOR Bryant Heat. & Air Cond VENTILATION SYSTEM ADDRESS 1350 E. Las Tunas Dr. EVAPORATIVE COOLER CITY San Gabriel :p J TEL. NO. 286-1141 STATE FLOOR BTU FURNACE: FAUGRAVITY LICENSE NO. 221751 CLASS C2 0 HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUPZONE PROCESs1D BY o-- WALL � 0 INSPECTION RECORD c3 w a Z Plan check fee 25% of above. I PERMIT ISSUING FEE $ 4 50 TOTAL FEE 34 50 f rI} I PLAN CHECK APPLICANT NAME ADDRESS CITY TEL.NO. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- LATING, AIR CONDITIONING. I HEREBY CERTIFY AT I AM NOT ACTING IN}�.11OLATION APPROVALS DATE INSPECTOR'S SIGNATURE OF CHAPTER 9, DTVI SIO�I , OF THE BUSINESS AND PR.GF,jiSSI ONAL ROUGH CODE OF THE STATE OFf IFORNIA. _ SIGNATURE FINAL OF PERMITTEE �� _ PLAN CHECK VALIDATION PERMIT VA ID ION CK. M.O. CASH CK, M.O. CASH 4 8 rt'y WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT 4 I',h affirm that I have a certificate of consent to self ,t,jps, "a'certificate of Workers' Compensation Insurance - AIR CONDITIONING or a certified copy thereof (Sec. 3800, Lob. ��C.)• 76A364C, CE-818(REV. 10/81) Policy No.' �� Company �e r+ Y y Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING tion d//epartmeent. a (PRINT OR TYPE ONLY) ADDRESS LOCALITY Date ~� a�`� "I` Applicant —`—�! �" NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST. t7 Qd%Ld?S (This section need not be completed if the work involved by ABSORPTION UNIT, BTU DISTRICT NO. PRO Y the permit is for one hundred dollars ($100)or less.) ` AIR HANDLING UNIT,CFM ' /, I certify that in the performance of the work for which this (f permit is issued, I shall not employ any person in any manner r so as to become subject to the Workers'Compensation Laws. BOILER, BTU APPROVALS DATE PTOR'S SIGNAT RE - COMPRESSOR, BTU �'� �,� � ROUGH - Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL 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 GP,4VITY LICENSED CONTRACTORS DECLARATION FLOOR BTU "�f 5"_79741 ! I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT `(commencing with Section 7000) of Division 3 of the Business WALL and Professions Code`,and my license is in full force and effect. -.6/ y License Number ��j Lic. Class ► U Contractor ILX—� " r Date O' ��" 0 ❑ I am exempt under Sec. LIJ CL Plan check fee #A B.&P.C. for this reasonZ PERMIT ISSUING FEE $ Q Date: 5U Signature' TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License Law for the following reason.(Section 7031.5, Business and NAME oil. 5 2 9.4 R Professions Code): ❑ I, as owner of the property, or my employees with ADDRESS 9 •,o o • s 8 wages as their sole compensation,will do the work and CITY TEL. NO. ( - 207.50 the structure is not intended or offered for sale(Section 7044, Business and Professions Code). r! ,j� ' �. I� ° ° 2� 7,5 d El I, c� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- MAILADDRESS ^(vf(, J -+`�" 0 8_21 —86 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY r, �, r`- TEL. NO. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CONTRACTOR (Sec. 3097, Civ. C.). ADDRESS Lender's Name / ry CITY j `yi�y.ir TEL. NO. 5`� / Lender's Address STATELIC. �ra ry�7 I certify that I have read this application and state that the LICENSE NO. T/ 37—� 7o CLASS 4 above information is correct. I agree to comply with all County or antes and State laws relating to building construction, and eZy authori a represents of this County to enter up o ,thelabov a en one(6 11 rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE $' oture of Applicant or Agent Date *: R;6' 'COMPENSATION DECLARATION APPLICATION FOR PERMIT insur�afirm cert'i cattel oft Work€rsriComte of pensat on Insuran eent to self or a certifiaed copy thereof (Sec. 3800, Lab. C.) 76A364C HEATING - VENTILATING - AIR CONDITIONING CE-818(REV. 10/81) Policy No. Company Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING tion department. ADDRESS 6019 BLADWIN (PRINT OR TYPE ONLY) Date Applicant LOCALITY TEMPLE CITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST LONGDEN (This section need not be completed if the work involved by ABSORPTION UNIT, BTU DISTRICT NO. PROCESSED By the permit is for one hundred dollars ($100)or less.) I certify that in the performan a work for whit AIR HANDLING UNIT, CFM permit is issued, I shall not a ploy a In in anne so as to become subject to a War 5 'On LOW BOILER, BTU APPROVALS DATE I bP TOR'S SIGNATURE Date — —R ri Appl ant COMPRESSOR,BTU O ROUGH �`� NOTICE TO APPLICANT: If, after king t Is erti of VENTILATION SYSTEM FINAL _ Oe,ZX�AV0 Exemption, you should b come ubject to the Workers' Compensation provisions of he L or Code, you must forth- EVAPORATIVE COOLER VALIDATI N with comply with such pro ns or this permit shall be 5_ deemed revoked. FURNACE: FAU AVIZY ��J LICENSED CONTRACTORS DECLARATION FLOOR BTU 6 I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED—UNIT— '(commencing USPENDED UNIT'(commencing with Section 7000) of Division 3 of the Business HEATER: WALL and Professions Code,and my license is in full force and effect. a c1 � 169,3A p Lice b r 99 Lic. Class C2O, C38 ► if ® 0 0 0 0 8 tr �. Con actor Date 3-12-85 I 0 ® 30,50 1— I a exempt under Sec. El 0 0 630, 50= UJ Plan check fee aL &P.C. for this reason PERMIT ISSUING FEE $ Q o3, 1 CL—8 5 Date: Signature TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and NAME Professions Code): ❑ I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section CITY TEL. NO. 7044, Business and Professions Code). ❑ 7L I, as owner of the property, am exclusively contracting OWNER with licensed contractors to construct the project (Sec- MAIL tion 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CIT TEL. NO. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CONTRACTOR '�'�` (Sec. 3097, Civ. C.). ADDRESS `I Lender's Name A CITY �i_t TEL. NO. r Lender's Address 4477 Imo' STATE LIC. Ice ti that I have read this application and state that the LICENSE NO. CLASS abo e i formation iscorre ee to comply with all County a ces and Stat s relati g to building construction, an h by th ' e re resent tives of this County to enter up n t a enti ed pr erty for i spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure of Applicant or Agent Date 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1306030005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91760 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 7 BL: .001 UN: .002 I 6019 BALDWIN AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802240 I (ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET: WOODRUFF 18587-032-001 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl 1 141 VENTILATION FAN 3.00 FAN 47.40 1 1 (TENANT: I TOTAL FEES 75.20 (ISSUED ON: PROCESSED BY: PLAN BY: I I 106/03/13 SR I (OWNER: TEL. NO: I IF AL DATE FI CODE: 1 IFIRST BAPTIST CH OF TEMPLE CITY (626) 286-3125- I 7 1 16019 BALDWIN AV 1 ITEMP 917801709 I D RIPTI N F WORK 1 1 13 VENTILATION FANS (APPLICANT: TEL. NO: I I IKITTERMAN, JOHN (626) 301-9546- I I I 1823 S MAGNOLIA AVE I ISPECIAL CONDITIONS: 1 IMONROVIA CA 91016 I 1 ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE IFINISHLINE CONSTRUCTION (626) 301-9546- 1 1 1823 S MAGNOLIA AVENUE LIC. NO I IFAU/WALL FURNACE (MONROVIA CA 91016 884981 1 11 1 ICOMBUSTION AIR OPENINGS I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IDUCT WORK I I 1 I I _ LIC. NO: i JAC/COMPRESSOR 11 I I I _ ITHERMOSTAT I I I IFIRE DAMPERS I I I I I ISMOKE DETECTION DEVICES 1 ICOMMERCIAL HOOD 1 I I I I I I I I I I I I I 1 I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I 1 I I I I I IREPORT ID: DPR264 ROUTE TO: BS0508 1 1 I I I I I I