HomeMy Public PortalAbout6014 BARTLETT AVE_Mechanical__ COLKrY OF LOS ANGELES TEMPLE CITY 0508 MECHANICAL. PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0012060011
r BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
BK: 24 PG: 87 PC: 2 6014 BARTLETT AV
FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: SGAB CA 917752612
NEAREST CROSS STREET: GARIBALDI
5386-013-028 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: G3 LOCALITY: TEMPLE CITY
30 AIR INLETS/OUTLETS 6.00 UNI 26.10
TOTAL FEES 53.85I MED ON: PROCESSED BY: PLAN BY: EXPIRES .
12/06/00 UT 06/05/01OWNER: TEL. K: FINAL DATE Fi CME:
.
SCHILZ JERRY L•STACI L - /_ Soo
6014 BARTLETT iV N V
SCAB 917752612 DESCRIPTION OF WORK
REPLACE 6 EXISTING DUCTS
APPLICANT: —TEL. NO:
RESCUE ROOTER (800) 269-6942-
475 ARROW HIGHLMY SPECIAL DITIONS:
COVINA, CA
5 PN(,ELES coCONTRACTOR: TEL. NO:
APPROVALS DATE INSPECTOR SIGNATURE
RESCUE ROOTER (800) 269-6942- '\.� �T}-
475 E. ARROW HIGHWY LIC. NO
COVINA, CA 91724 744542 B COMBUSTION
ARCHITECT DUCT WORK
LIC. NO 111111
THERMUSTAT
FIRE DAMPERS
U IE7-1)L C W 0
011
❑
46��c Ser
vice
* ADDITIONAL DATA ON FILE
REPORT ID: DPR264 ROUTE TO: BS0508
76A364 - CE818 - 3-69 • APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS 41
BUILDING AND SAFETY DIVISION r
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY0 4e
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN ow NE �-t/
(PRINT OR TYPE ONLY) y
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE DDRESS0/5e- /1-11
ABSORPTION SYSTEM, BTU CIT �v/� TEL. N0. Q
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS r
BOILER, HORSEPOWER
to-
CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DIDTR14T X0. GROUP ZONE PR SSED BY
EVAPORATIVE COOLS ♦/¢)� /
FURNACE: FAU ke GRAVITY
FLOOR BTU O INSPECTION RECORD
EATER: SUSPENDED UNIT
WALL
O
- V
cc
O
NEW—ADDITION— PERMIT $ 3 00 Z
ALTER--REPAIR_ TOTAL FEE $ b
PLAN CHECK APPLICANT
NA M E
ADDRESS
C I T Y LZ TEL. N
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI-
LATING, AIR CO ITIONING. APPROVALS DATE INSPECT R'S SIGNATURE
I HEREBY ER FY THAT 1 AM NOT ACTING IN VIOLATION OF ROUGH
CAPTER 9 DIVI ION S, OF T BUSINESS AND PROFESSION-Al-
CHFINAL
ODE OF T E ST T OF CALIF IA.
SIGNATURE JACK R. AL N, SUPER MECHANICAL ENG'R.
OF PERMIT �!I/�`[�/�!� SSSIII
PERMIT VALIDATION CK. M.O. CASH
PLA HECK VALIDATION
5 7 0 7g JUL 5 4 1 A 8.00
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS' COMPENSATION DECLARATION
t APPLICATION FOR P E RM I T
L}r6�eby affirm that I have a certificate of consent to seFf
Insure, or a certificate of Workeri Compensatlon Insurance, HEATING - VENTILATING - AIR CONDITIONING
or tp certified copy thereof (Sec. 3800, Lab. C.) 76A364C
20.0046 DPW 9/88
Policy No Company
0 Certified copy Is hereby fur (shed. COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified.copy Is the ty buildln I FOR APPLICANT TO FILL IN BUILDING / L-c��_
tlon depa (PRINT OR TYPE ONLY) ' ADDIS O" y
Do - - lic—tant , LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION,INSURANCE CROSS ST.
(This section need not be co
rrsptoted FF the work Involved by ABSORP1lON UNIT;BTu pS�NO. BY
the permit to for or►e hundred dollars ($10D) or New.)
I certify that In the perfdrmance of the work for which t s AIR H4tDIJNG UNIT, CFM �D Q
permit Is Issued, I shall not employ any person In any man O
so-as to ber;ome subject to 1he Workers' Compensat n BTU APPROi DATE it 7ar5 stCNAtuRf
Data "Applicant COMPRESSOR, BTU _/ 4� ROUGH
NOTICE TO APPLICANT: If, after making this Cert cat of VENTILATION SYSTEM F1 NAL
Exemption, -you should be-coma- sublect. to the Wo rs'
Compensatlon provlsigns of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATION
with comp)yy,with such prpvlslons or this permit shall be deem-
ed revokgd. / RJRNACE: FALI GRAVE
UCENSED CONTRACTORS DECLARATION / FLOOR BTU
affirm
D D
1 hereby arm+'gt I am licensed under provlsiors of Chapter 9 HEATER. SUSPENDED UNIT—
(commencing with Section 7000)of Dlvlslon 3 of the Business WALL
and Profgsslons Coder and my license Is In full force and effect.
CL
Ucense Number 9--3 q / I Llc. Clain O
L u
6cc
Contractor Datexempt undd O
OD
❑ I am eer Sic rj
Plan check fee
B.BP.0 for This reason PERMIT ISSUING FEE $ as fT.i w
Data: D7 7 .
Signature TOTAL FEE �a
1 ITE'IS
OWNER-BUILDEIR DECLARATION PLAN 0-1-CK APPLCANT
37 - 00
I hereby affirm that I am exempt from the Contractors License , ��T�-
Low for the following reason (Section 7031.5, Business and NAME 0 ' e ''
Professions Code):
DECK J�.LTJ
❑ I, as owner of the property, or my 'employees with CHANIZ CACI
wages as their sole compensation,will do the work and TEL 13
the structure Is not IntendqN
Intended or offered for sale(Section
7044, Business and Professions Code). OVJt R. Yt4 4 E+y / T q Q010115-1011M1 I1 16/9113
❑ .I, as owner of the property, am exclusively contracting , 1F� r,c
with licensed contractors to construct the project (Sec- Mf+IL I r e ?07V 1 AM 11:OF,
tion 7044, Business and Professions Code). olq ADDRESS
CONSTRUCTION LENDING AGENCITY N TEL Nlziv
_
I hereby affirm that there Is a corstruction lending agency for
the performance of the work for which this permit Is Issued CONTRACTOR ,
(Sec. 3097, CI v, C.}
ADDRESS
Lender's Name
CITY BN 1`� !fe//O TE- � a
� 7-97 V
Lenders Address
I certify that I -have read this appllcatlon and state'hat the STATE CESE NO /� UC. _
above Information Is correct. I agree to comply with all County
ordinances and State laws roIng to bullding construction,
and hauthorize ro tatives of this County to enter
er
p above-men pert-for Inspection purposes.
SEE REVERSE FOR EXPLANATORY LAN rUAGE
Sig re of Applicant or 1nt Date