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HomeMy Public PortalAbout9468, 9458 BROADWAY_Mechanical__ WORKER'S that have a certificate DECLARATION ]8A3640 PW 9189 APPLICATION FOR PERMIT �� � GREEK. 1 hereby affirm that have a certificate of consent to self insure, or a certificate of Workers Compensation Insurance, or a certified HEATING-VENTILATING -Alf; CONDITIONING copy thereof(Sec.3800 Lab..C.) - - - �t J-60i t3 ST^T�.�ti L� Policy D. Company COUNTY OF LOS ANGELES' � DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. Certified copy is hereby furnished. ® Cedified co Is filed with the county building Inspection FOR APPLICANT TO FILL IN BUILDING copy y g PRINT OR TYPE ONLY ADDRESS ((J J}L department.(� ( 1 Date O _V APPlicanfand4A 190,) LOCALITY --r.A Le NO. TYPE OF APPLIANCE OR EQUIPMENT FEE I _ CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST r COMPENSATION INSURANCE , ABSORPTION UNIT,BTU_ CROSS ST. Z_")- L (This section need not be completed if the work involved by the MAP BOOK PAGE PARCEL permit is for one hundred dollars(8100)or less.) AIR HANDLING UNIT,CFM DlsmlcT rvo. PRocsssso By I certify that in the performance of the work for which this permit , is issued, I shallnot employ any person in any manner so as to BOILER,BTU become subject to the Workers' Compensation Laws. COMPRESSOR,BTU APPNOVALS DATE INSPECTORs SIGNAPPRE 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 V FAU GRAVITY - LICENSED CONTRACTORS DECLARATION FLOOR rft-'y�BTU ��C.�OOB 51 o VALIDATION I hereby affirm that I am licensed under provisions of Chapter 9 _ SUSPENDED 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. HfoA T '/� Lia Classa d =33�u License Number n� � a ContractorJO�ANA`R-' Data IOj;L 7 7 m f 0 U ❑ am exempt under Sec. Plan check fee CHECK 1. .7[j Cc B.RP.C.for this reason PERMIT ISSUING FEE.$ '-i,;=i't'itaE , 'I Data: TOTAL FEE 170 LU Signature PLAN CHECK APPLICANT -' S IIIfI—[!I I;.i (j(' j/4=;t a. C13OWNER-BUILDER DECLARATION Z I hereby affirm that I am exempt from the Contractor's License LawNAME - D - JYi_t ? D, I for the following reason (Section 7031.5, Business and Professions Code): ADDRESS ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the CITY TEL.NO. structure is not intended or offered for sale (Section 7044, Business and Professions Code). OWNER ns [,t /Q C ❑ 1, as owner of the property, am exclusively contracting MAIL /+ / with licensed contractors to construct the project (Sec- ADDRESS r"/ _ tion 7044, Business and Professions Code). 1 , CONSTRUCTION LENDING AGENCY CITY l��E C v TEL.NO. hereby affirm that there is a construction lending agency for ONTRACTOR the performance of the work for which this permit Is issued (Sec. 3097,Civ. C.). - ADDRESS Lender's Name n t^__ p CITY 6!� ,ibo TEL.NO. - Lender's Address certify that 1 have read this application and state that the above LICENSE NO.TATE G 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 inspec on purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE brUgTURFYFAPPUCAN+(J AGENT DATE - WORKER'ShaWNSATION DECLARATION 76A30-00446 C 9/09 APPLICATION FOR PERMIT I� ME GREE I herebyac affirm that I have a certificate of consent to salt insure, i or a certificate of Worker's Compensation Insurance, or a certified HEATING -VENTILATING-AIR CONDITIONING copy thereof(Sec.3800 Lab. C) - -- - Policy No 2996971' Company S'�'��C Fc{.ti'4 COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. Certified copy is hereby furnished. Certified copy is filed with the county building inspection FOR APPLICANT TO FILL 1N '- BUILDING q p p� �9Z�'/ depanment. (PRI NT OR TYPE ONLY) ADDRESSDate F-"$ Applicant TUK/1AA�/� TY nA0 N0. TYPE OF APPLIANCE OR EQUIPMENT FEE CCERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST. �D VE I ABSORPTION UNR.BTU ASSESSOR (Thio section neetl not be eompletetl if the work Involved by the MAPBOOK PAGE permit is for one hundred dollars($100)or less) AIR HANDLING UNIT,CFM Dlsrfllcr ND. gocsssE.r2 I certify that in the performance of the work for which this permit /�NO 4y�/ is issued, I shall not employ any person in any manner so as to BOILER,BTU - f become subject to the Workers'Compensation Laws. COMPRESSOR,BTU �� OOO �J• (� APPflOVA45 DATE INSPECTOas aIDNANPE Date Applicant VENTILATION SYSTEM NOTICE TO APPLICANT: If, atter making this Certificate of ROUGH Exemption, you should become subject to the Workers'Compensation EVAPORATIVE COOLER provisions of the Labor Code, you must forthwith comply with such FINAL provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION If I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED—UNIT— (commencing USPENDED UNIT_(commencing with Section 7000) of Division 3 of the Business and HEATER: WALL Professions Code,and my license is in full force and efffeect, - u © ./S� �0 �O License Number .S GO Y-1/ Lic.Class �-G D a Contractor SOe�DAnlA/.e Date -DU�--�-5 0 ❑ I am exempt under Sec. Plan Check fee 8 V B.BP.C.for this reason PERMIT ISSUING FEE$ QO "L 7r( (— Date: _?K1? ltv..�� (� TOTAL FEE Signature D 1 -T ;.I IBJ g PLAN CHECK APPLICANT i ITEM,tl f--• � OWNER-BUILDER DECLARATION i"f`,1 126 -30 ? I hereby affirm that I em exempt from the Contractor's License Law NAME t AL i for the fallowing reason (Section 7031.5. Business and Professions Code): ADDRESS t� t�LC ❑ I, as owner of the property, or my employees with wages CHANGE ' as their sole compensation, will do the work and the CITY TEL.NO. structure is not intended or offered for sale (Section 7044, ❑ Business and Professions Code). OWNER O/alaola-�nalai t;. t 1, as owner of the property, am exclusively contracting MAIL AM with licensed contractors to construct the project (Sec- ADDRESS (o;� �O D�./.yy 6401 i Ahi i if tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY C > TEL.NO. �C hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued CONTRACTOR ��q SQ� D _ - (Sec.3097,Civ.C.). /7 6 , -r ADDRESS /Z ire/ENO ✓� - Lender's Name CITY O TEL.NO. Lender's Address I certify that I have read this application and state that the above STATE CENSE NO., p ,2 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 proper or inspection urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE IATUq FAPPLICAM AGENT DATE TION ♦ WORKERS t I have a certificate f corse APPLICATION FOR PERMIT I hereby affirm that I have a certificate of consent to self PY IL '4.YY II CI iN9 insure, or a certificate of Workers' Compensation Insurance, 76A364C HEATING - VENTILATING - AIR CONDITIONING or a certified copy thereof(Sec. 3800, Lab. C.) 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 deportment. (PRINT OR TYPE ONLY) ADDRESS Date Applicant - LOCALITY ..w! NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST ^ COMPENSATION INSURANCE - CROSS ST. �V' L (This section need not be completed if the work involved by ABSORPTION UNIT, BTUpIBiRICS NO. PROCESSED BY the permit is For one hundred dollars ($100)or less.) AIR HANDLING UNITCFM, certify that in the performance of the work for which this ✓ permit is issued, shall not employ any person in any manner Sa a5 t0 B2cOmE SU612C��f 10 the WO�4kers BOILER, BTU Compensation Laws. APPROVALS DATE INSPECTOR'S SIGNATURE Date 6n - �Z '!{pa / nt 1` 1V COMPRESSOR, BTU I ROUGH —(3 _rte 6-,�, NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL 7 Exemption, you should become subject to the Workers' _ v 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 FLOOR BTU 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 - WA and Professions Code,and my license is in full force and effect. 1 License Nuym�ber a�c,z/�C-- Lic. Class C 6 D _ Contractor✓ /'�C6� �LI�!: Date ��/3��y - O H 1 am exempt under Sec p Plan Check fee 1 B.BP.C. for this reason-- AVO rf-y L16" '!, PERMIT ISSUING FEE $ z Signature //iu.�-uA JY/.4�. TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License e Law for the following reason (Section 7031.5, Business and NAME LQ G.-/{.(�>(cL. �• Professions Code): ' / ❑ I, as owner of the property, or my employees with ADDRESS w L/ ,U 2,1 9 5 6 A wages as their sole compensation,will do the work and r e e e °-e the structure is not intended or offered for sale (Section ITY• t�se�i.lXi ry TEL. NO. Z.SZ,�/.�g 8 7044, Business and Professions Code). OWNER 12 ° ° 5,Q 5 0 ❑ I, as owner of the property, am exclusively contracting MAIL ° ° ° 5 Q 5 0 z with licensed contractors to construct the project (Sec- gDDRE55 o tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY TEL. NO. 0.6.,1 3-84 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CONTRACTOR �,f� �D/ • / xGsl'SL- D (Sec. 3097, Civ. C.). ADDRESS/? -2 s1/ - L'YLs'.� — S,T ' Lender's Name CITY TEL. NO. Lender's Address STATE LIC. I certify that I have read this application and state that the - LICENSE NO. CLASS .. above 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 I'/u n the above-me ntio}n/fie/dJ�pr/operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY ti-0508- ' MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9610030002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDR SS: ON FILE '9468 BROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802445 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8588-027-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY 02 COMPRSR < 100 KBTU '2.00 COM 54.00 TENANT: 08-FURNACE/HEATER <100 5.00 UNI 135.00 TSSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 30 AIR INLETS/OUTLETS 8.00 UNI 34.80 10/03/96 TC 10/03/97 TOTAL FEES 251.55 OWNER: TEL. NO: FINAL DATE FINAL BY: ODE: REORGANIZED CHURCH OF (714) 639-8761- 393 TUSTIN ST DESCRIPTION OF WORK REPLACE HEATING AND A/C SYSTEM AP LIC T: TEL. NO: JORDANAIR (818) 963-3313- 129 S. HACIENDA AVE &eL E S ® SPECIAL CONDITIONS: GLENDORA, CA CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE JORDANAIR (818) 963-3313- 129 S. HACTENDA AVENUE LIC. NO ' Pa ys FAUIWALL FURNACE GLENDORA, CA 91741 560429 C20I i i ➢ COMBUSTION AIR OPENINGS ARCHITECT OR NG EER: TEL. O: DUCT WOR LIC. NO: , AC/COMPRESSOR O HER S AT P U 8 L C W®R tl�s S FIRE DAMPERS SMOKED EC I-�OWDE I O 0 i COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY g 0508 .;p MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS rl ME 0508 0611010009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: '(+� LEGAL ID: FEES PAID _' BUILDING ADDRESS: , ON FILE 9466 BROADWAY FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917602445 ASSESSOR INFORMATION NUMBER: y) NEAREST CROSS STREET: 8586-027-001 - 01 PERMIT ISSUANCE FEE 27.75 I` THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C BT 02 COMPEER c 100 KU 1.00 COM 27.00 l" TENANT: 08 FURNACE/HEATER x100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: LINDA READ CHURCH CONTACT TOTAL FEES 81.75 11/01/06 JK 04/30/07 OWNER: TEL. NO: FIN DATE FINAL BY: CODE: COMMUNITY OF CHRIST (909) 631-0393- j//'� 9468 E. BROADWAY TEMPLE CITY CA 91780 DES IPTION OF WORK HVAC CHANGE OUT APPLICANT: TEL. NO: JORDANAIR INC. (626) 963-3133- 129 S. HACIENDA AVE SPECIAL CONDITIONS: GLENDORA, CA 91741 :i CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE JORDANAIR INC. (626) 963-3313- 129 S. HACIENDA AVE LIC. NO FAU/WALL FURNACE GLENDORA, CA 91741 560429C20B COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK LIC. NO: AC/COMPRESSOR THERMOSTAT FIRE DAMPERS SMOKE DETECTION DEVICES COMMERCIAL HOOD I � r .. ( ADDITIONAL DATA ON PILE r REPORT ID: DPR264 ROUTE TO: BS0508 �l r . �t ) COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0009140001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEG ID: FEES PAID BUILDING ADDRESS: ON FILE 9468 BROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802445 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8588-027-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY 30 AIR INLETS/OUTLETS 10.00 UNI 43.50 TENANT: TOTAL FEES 71.25 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 09/14/00 UT 03/14/01 OWNER: TEL. NO: FINAL DATE FIJI CODE: 393TUSTINS REORGANIZED CHURCH HURCH OF (714) 639-8761- q-qg C / ORANGE, CA 92866 VbE3CRI•LPTION OF W RK FIVE NEW INLETS AND FIVE OUTLETS APPLICANT: TEL. O: CORCORAN 8 CORCORAN (949) 650-0600- 2240 UNIVERSITY DR. SPECIAL CONDITIONS: NEWPORT BEACH, CA P14GELES CO CONTRACTOR: TEL. NO: �O�j APPROVALS DATE INSPECTOR SIGNATURE MEADOWS MECHANICAL (310) 615-1125- 410 S DOUGLAS ST LIC. NO FAU/WALL FURNACE EL SEGUNDO, CA 90245 383620 / COMBUSTION AIR OPENINGS ARCHITECT OR ENGINE R: TEL. N0: DUCT WORK CORCORAN AND CORCORAN (949) 650-060go�j�2240 UNIVERSITY DRIVE #120 LIC. NOAC/COMPRESSOR NEWPORT BEACH, CA 92660 THERMOSTAT I G�FI B C t\ n pO�N// FIRE DAMPERS I U ILIA \\l�lll pull IUK(\1 SMOKE DET CTION DEVICES { COMMERCIAL HOOD SU2 YP.L 10 El cl ' f �r^•i serviOce That��t REPORT ID: DPR264 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 9906010003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: - GAL FEES PAID BUILDING ADDRESS: ON FILE 9468 BROADWAY FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: TEMP CA 917802445 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: CLOVERLY 8588-027-001 OW P.C. FEE 8109.35 MIN 6-00 656.10 THOMAS PAGE: 596 GRID: A LOCALITY: TEMPLE CITY 01 PERMIT ISSUANCE FEE 27.75 TENANT: 02 COMPRSR < 100 KBTU 2-00 COM 54.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 08 FURNACE/HEATER <100 2.00 UNI 54.00 06/08/99 UT 12/05/ 9' 30 AIR INLETS/OUTLETS 18-00 UNI 78.30 OWNER: TEL. NO: TOTAL FEES 870.15 FINAL DATE FINAL BY CODE: REORGANIZED CHURCH OF (714) 639-8761- 393 TUSTIN ST 2�Z 06 A ORANGE, CA 92866 -DE-SCWTPTFON Of WURK NEW HEATING AND COOLING SYSTEMS FOR REMODELING OF STRUCTURE APPLICANT: TEL. CORCORAN & CORCORAN (949) 650-0600- 2240 UNIVERSITY DR. SPECIAL CONDITIONS: NEWPORT BEACH, CA PNGELES Co CONTRACTOR: TEL. NO: QS U�/�. APPROVALS DATE INSPECTOR SIGNATURE MILLER AIR DESIGN (714) 632-9828- 2941 E. MIRALOMA #6 LIC- NO F FURNACE ANAHEIM,CA 92806 498849 C20 COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. 0: CT CORCORAN AND CORCORAN (949) 650-0600- - - 12240 UNIVERSITY DRIVE #120 LIC. NO/� 11111,1 AC/COMPRESSOR NEWPORT BEACH, CA 92660 NONE THERMOSTATv . U� FIRE DAMPERSU ` nO� Vs vO TM-0-KFUMC-T-ION DEVICES U COMMERCIAL HOOD O [J yEl £!p o (19m c� Gc- Service REPORT 10; DPR264 ROUTE TO: BS0508