HomeMy Public PortalAbout5918 CLOVERLY AVE_Mechanical__ 7EA36 18-- 3=69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES 7NEAREST
8 North Cloverl
DEPARTMENT OF COUNTY ENGINEER y
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER m le Cit
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) T. C . Masonic Temple Assn,
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS 5918 N. Cloverly
2 ABSORPTION SYSTEM, BTU4-ton ea 8 00 CITY Temple City TEL. N%27 ;
AIR HANDLING UNIT, CFM CONTRACTOR Br ant Htg. & Air Cond . Inc.
_
ADDRESS 1350 E. Las Tunas Drive
BOILER, HORSEPOWER
CITY San Gabriel 1I-7TL. N0. 286-1141
COMPRESSOR, HORSEPOWER
_ STATE LIC.
LICENSE NO. 221751 CLASS C20
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE ,PR ESSSEEDD�BY
EVAPORATIVE COOLER
r 1 FURNACE: FAU200�00u - 5 00
FLOOR BTU INSPECTION R CORD.
HEATER: SUSPENDED UNIT J/� 1/ i•
WALL 4l n
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2 ! �
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NEW—ADDITION_ PERMIT $ 3 00
Is.
ALTER--REPAIR— TOTAL FEE $ 16 00 },f '•_�-h .. '
PLAN CHECK APPLICANT
NAME
ADDRESS
r•
CITY TEL. NO. /O� �(� �'r/�t _ r/vlL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION /py' S
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY /Q//, . •y�, �A -�i�/•' .o?_
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING. - _ 4 t
I HEREBY CERTIFY THAT I AM NOT ACTING IN IOLATION OF ROUGH
CHAPTER 9, DIVISI 3, OF THE BUSINESS AND OFESSIONAL FINAL r`� r��.• i'��COD OF THE S F CALIFORNIA.
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMIT
PERMIT VALIDATION K:r M.O. CASH
PLAN CHECK VALIDATION
`EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS'COMPENSATION DECLARATION CEA 81 8 (2-80) /n1 LL,�C G=�T OO �l FOR ff� If1S V�%U ��
I hereby affirm that I have a' certificate of consent to self
insure, or a certificate of Workers'Compensation Insurance,of HEA71NG-V[ENTIL,ATIIrt'lG-Alfa CONDITIONING
a certified copy thereof(Sec. 3800, Lab.C.)
Policy No.�4!d2__586 Company State Faced
COUNTY'OF LOS ANGELES T, BUILDING AND SAFETY
Certified copy is hereby furnished. P
E3, Certified copy is filed with the county building inspection BUILDING
department//. FOR APPLICANT TO FILL IN ADDRESS
Date 1-1/30/83Applicant AAA Cond. Air, rne. (PRINT OR TYPE ONLY) 58� Qt �
CERTIFICATE OF EXEMPTION FROM WORKERS'
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Tem 2e City
COMPENSATION INSURANCE NEAREST }
CROSS ST.
(This section need not be completed if the work involved ABSORPTION UNIT, BTU �� 4 d
by the permit is for one hundred dol''ars ($ICO) or less.) DISTRICT NO. r
CE$ -D BV O
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM �^/
permit is issued, I shall not employ any person in any manner J
so as to become subject to the Workers' Compensation Laws. I BOILER, BTU O
OHO APPROVALS DATE I INSPECTOR'S SIGNATURE V
Date Applicant 3 COMPRESSOR,BTU �� "'•• �� ROUGH �L' N
NOTICE TO APPLICANT: If, after 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- I VALIDATION
with comply with such EVAPORATIVE COOLER
p y provisions or this permit shalt be r/�-Z
deemed revoked. FURNACE: FAIXr
LICENSED CONTRACTORS DECLARATION -1 FLOOR,: BTU
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 293529 Lie.Class C20
Contractor AAA Cond. Aitoate 2113083
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- PERMIT ISSUING FEE $ /� d ;'7 2'6,9 A
Bus-
iness and Professions Code).
Lie.or Reg,No. Date TOTAL FEE K0
— '' c o 0 0 0
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
50
I hereby affirm that a am exempt from- the Contractor's NAME 2 0`o 0,
License Law for the following reason (Section 7031.5, Busi- c o o 4 0.5 0 e
Hess and Professions Code): ADDRESS � 201 —g,'J
I, as owner of the property, will do the work and the TEL. NO.
structure is not intended or offered for sale (Section CITY
7044, Business and Professions Code).
a OWNER le City Masonic Lod e
I, as owner of the property, am exclusively contracting Temple 9
with licensed contractors to construct the project MAIL
(Section 7044, Business and Professions Code). ADD RESS59I8_CIQPerly—AVelIt2
CONSTRUCTION LENDING AGENCY CITY q�eiv a City TEL.NO.•280-3336
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is CONTRACTOR AAA Conditb*_nod__A1r,_Z
issued(Sec. 3097,Civ.C.).
Lender's Name ADDRESS 30260 S. Valley 'B3Vd
Lender's Address CITY TEL. NO.
El 017te 5.7.9�i_8tL
I certify that I have read this application and state that the STATE LIC.
above information is correct.1 agree to comply with all County LICENSE NO. 293529 CLASS C,20
ordinances and State laws regulating Heating. Ventilating and
Air Conditioning,and 1--reby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter vaon the aF^ a mentioned property for
inspection purposes
David Cross 12/30/83
Signature of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9710090004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING DD SS:
TR: 6561 LT: 293 BL: .001 5918 CLOVERLY AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802018
ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET: LAS TUNAS
8587-013-019 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
08 FURNACE/HEATER <100 2.00 UNI 54.00
TENANT: TOTAL FEES 81.75 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES OW-
10/09/97
:10/09/97 UT 10/09/98
OWNER: TEL. NO: FINAL DATE FINAL BY: ODE:
AMITABHA PURELAND, INC. (626) 282-3700- .7
82-3700- 10-16
�,,,�/
5918 CLOVERLY AV / (Q
TEMP 917802018 DESCRIPTION OF WORK
INSTALLATION OF TWO COMFORT HEAT UMP SYSTEMS
APPLICANT: EL. NO:
A B C CONDITIONED AIR (818) 454-1500
SPECIAL. CONDITIONS:
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
A B C CONDITIONED AIR (626) 454-1500-
r
10160-62 VALLEY BLVD LIC. NO FA /WALLFAU/WALL FURNACE
EL MONTE, CA 708118010
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. N0: /'� �� �" - ` `, DUCT WORK
LIC. N0: AC/COMPRESSOR
-
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
17
% COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508