HomeMy Public PortalAbout6015 ENCINITA AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508^ MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9610240008
f- BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDI G ADDRESS:
TR: 5904 LT: 380 6015 ENCINITA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801935
ASSESSOR-INFORMATION NUMBER: NEAREST CROSS STREET:
5384-013-024 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 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 BY: PLAN BY: EXPIRES ON:
30 AIR INLETS/OUTLETS 9.00 UNI 39.15 10/24/96 TC 10/24/97
TOTAL FEES 120.90
OWNER: TEL. NO: FINAL VTE-1 �7 FINAL �(': CODE:
NALICK DAVID;BONNIE A(/
6015 ENCINITA91780193 AV
TEMP 917801935E>�P ION F WORKAPPLIC NT: TE
L. �� NEW HF.AT[NG AND A/C SYSTEM
N0:
HUNTINGTON AIR COND. (818) 285-5049-
450 AGOSTINO RD. oz
SPECIAL CONDITIONS:
SAN GABRIEL, CA 0
CONTRACTOR: TEL. NO: �® ; O • APPRO\'ALS DATE INSPECTOR SIGNATURE
HUNTINGTON AIR CONDITIONING, INC. (818) 285-5049-
440-450 AGOSTINO ROAD LIC. NO ( FAO/WALL FURNACE
SAN GABRIEL, CA 91776 644769 C20 """ --
� �_-` COMBUSTION AIR OPENINGS
ARCHITECTOR ENGINEER: TEL. N0: �Un/\ QJJ I!I( 1 DUCT WORK
LIC. NO: AC/COMPRESSOR
THERMOSTAT
( F�[RE DAMPER
SMOKEUET LTIO� N DEVICES
_ A COMMERCIAL HOOD
®� STI
REPORT ID: DPR264 i ROUTE TO: BS0508
• "WORKER'S COMPENSATION DECLARATION 20 W46 DPW 9/89
76A364C APPLICATION-FOR PIERMIT UME GREE,
6A384
I hereby affirm 9hafl have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a certified HEATING"VENTILATING , AIR CONDITIONING - -
copy'thereof(Sec. 3800
SClo
38�0�0�Lab. C. I .. - ` . �' •
Policy Na.J._!-t_.lse mnjany, C N A A" C-* COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
Certified copy is hereby furnished.
-
FV'Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING // A
department. (PRINT OR TYPE ONLY) ADDRESS rp Q1.5 ,
F�—��
Dale Applican LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE _
CERTIFICATE OF EXEMPTION FROM WORKERS' ' NEAREST _ •
COMPENSATION INSURANCE CROSS ST,
ABSORPTION UNIT,BTU ASSESSOR" p
(This section need not be completed 0 the work involvetl by the MAP BOOK �� d PAGE �i/3 PARCELQa
permit is for one a performance
antes($100)or less.) AIR HANDLING UNIT,CFM
pISTRICT NO. PROCESSED,.8y
I caI'tity that in the performance of the work for which this permit - -
is issued. I shallnotemploy any person in any manner so as to .BOILER,BTU
become subject to the Workers' Compensation Laws. - per
COMPRESSOR,BTU
APPROVALS DATE .I NSPECTOR'a SIGNATUPE
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: FAU_GRAVITY - - -
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION '
.I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED UNIT_ QQ •(�
(commencing'with'Section 7000) of Division 3 of the Business and HEATER: WALL �— r✓
Professions Code, and my license is in full-force and effect.
License Number ' Lic.Class
Contractor ►. Y rt'c/..� �' i[l ^f;, O
F-1I am exempt under Sec. U
Plan check fee Q
e f
BAP.C.for this reason PERMIT ISSUING'FEE $ S '• - € e€' 0
Date TOTAL FEE ZIP 1
Signature O CHECK
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT _ �
: 4F1 11 E ,;_ji l Z
'I hereby affirm that I am exempt from the Contractor's License Law NAME D
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. Qi_ISTtr j y�'� 4a'D�
structure is not intended or offered for sale (Section 7044,
Business and Professions Code). OWNER
❑ I, as owner of the property, am exclusively contracting MAIL A
with licensed contractors to construct the project (Sec. ADDRESS Q
tion 7044,CONSTRUCTION PLENDING AGENCY _
CITY TEL.NO.rofessions Code)
�?
hereby affirm that there is a construction lending agency for pNTRACTO
the performance of the work for which this permit Is issued C,
(Sec.3097,Civ.C.). - 1" D' '• m• t
ADDRESS -
1
Lender's Name I
CITY Y V y� —'? TEL.NO4 ` ,/�. ` VOA7 .. ._
Lender's AddresSl./� •nv.ry_n LA4
I certify that I have read this application and state that the above 'LICENSE NO.P3 1 CSSc J'6�
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
p p rb fo 'nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -
�{ -2-4 --9 �.
SIGNA EOF APPpCANT Ofl AGENT DATE -