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HomeMy Public PortalAbout5016 FARAGO AVE_Mechanical__ 76A364—CE818—1/70 APPLICATION FOR P MIT .1 HEATING - VENTILATING - AIR'CONDITIONING , COUNTY OF LOS ANGELES - ADDR°Es"s D/� .�✓.¢ DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETYrDIViS10N LOCALITY JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING NEAREST CROSS ST FOR APPLICANT TO FILL IN OWNERG �7F� (PRINT OR TYPE ONLY) 12 1 MAIL 4 NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS T:ZEVVV,/�Pi TEL NO l �r ABSORPTION SYSTEM,,BTU M CONTRACTOR AIR HANDLING UNIT, CFM ' ADDRESS BOILER, HORSEPOWER - CITY _ Z��� TEL NO�.,q IvI COMPRESSOR, ORSEPOWER STATE O - ` HLI,C �7 f LICENSE NO S_ ` CLASS pc O + VENTILATION SYSTEM fDISTRICT NO CLASS GROUP ZONE PROCESSED BY EVAPORATIVE COOLER FURNACE FAU `GR TY FLOOR BTU INSPECTION RECORD / HEATER SUSPENDED UNIT_ WALL a - D rE } NEW �'ADDITION— PERMIT $ .r 3 00 Z ALTER—REPAIR_ TOTAL FEE $ r PLAN CHECK APPLICANT 1 / s NAMEIO e y a��% �h ` ADDRESS(, 16 A,f9 D J LLATING %ii1 1 TEL NO EBY ACKNOWLEDGE THA I HAVE READ THIS APPLICATION ` TE THAT THE ABOVE IS CORRECT`,AND AGREE TO COMPLY L ORDI NANCES'AND LAWS REGULATING HEATING, VENTI APPROVALS rDe TE r + N ECTOR'S SIGNATURE + AIR CONDITIONINGROUGH REBY CERTIFY THAT I AM NOT ACTING IN VIOLATIONof TER'9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL THE STATE CALIFORNIA )`URE ` JACK R ,ALLEN,SUPERVISING OHANICAL ENG'RMITTEE " PERM'IT'VALIDATION cK M O CASH PLAN C CK VALIDATION , ;0,4� JL{IJ 2 8 4 1 0 1 1 .00- L 'SEE BACK OFAPPLICATION FOR COMPLETE FEE SCHEDULE V""�� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKSf 9701 LAS TUNAS ME 0508 1101060006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 11497 LT 14 BL B 1 5016 FARAGO AV I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803525 1 (ASSESSOR INFORMATION NUMBER 1 I NEAREST CROSS STREET 18574-009-049 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY, CI, 1 141 VENTILATION FAN 1 00 FAN 15 80 I I TENANT 1 TOTAL FEES 43 60 (ISSUED ON PROCESSED BY PLAN BY I 1 101/06/11 SR I I 1 1OWNER TEL NO I 1F NAL DATE FINNY CODE 1 TONG AMANDA (6 2 6) 616-1719- 1 1 620 RAMONA ST #B 1SAN GABRIEL CA 91776 I 1D CRIPTI N OF WORK 1 IVENTILATION FAN FOR POWDER ROOM I 1APPLICANT TEL NO I 1 1TONG, AMANDA (626) 616-1719- I I 1 1620 RAMONA ST #B I ISPECIAL CONDITIONS I ISAN GABRIEL CA 91776 I I 1 ICONTRACTOR TEL NO 1 IAPPROJALS DATE INSPECTOR SIGNATURE 1 IFUN ON CO (323) 842-8306- 1 1 1 11948 LANSDOWNE AVE LIC NO 1 1FAU/WALL FURNACE 1 1 1 ILOS ANGELES CA 90032 685987 I 1 1-1 1 I I ICOMBUSTION AIR OPENINGS I I 1 (ARCHITECT OR ENGINEER TEL NO1 IDUCT WORK 1 I _ 1 1 1 LIC NO i IAC/COMPRESSOR I 1 I 1 1 ITHERMOSTAT 1 1 I I I I 1 I IFIRE DAMPERS 1 1 1 i I I I 1 1 ISMOKE DETECTION DEVICES I 1 1 1 1 (COMMERCIAL HOOD 1 1 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 IREPORT ID DPR264 ROUTE TO BS0508 I I I I I I WORKERS' COMPENSATION DECLARATION APPLICATION FOR PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified copy,thereof�(Sec. 3800, Lab. C.) 76A364C . 20-0046 DPW 9/88 Policy No. Crompany `"�' r ❑ Certified copy is hereby furnished ,° ��. � fi'''r COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is filed with the county building inspec- BUILDING f Z tion department. ,, FOR APPLICANT TO FILL IN ADDRESS is ''f,' 4s ✓4�. ";V a (,f " �� S( �•�� r (PRINT OR TYPE ONLY) Date Applicant `� ` LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' / NEAREST COMPENSATION INSURANCE CROSS ST. BTU (This section need not be completed if the work involved by ABSORPTION UNIT, DISTRICT NO. f PROCESSED BY ' the permit is for one hundred dollars (;100) or less.) AIR HANDLING UNIT, CFM 'r ; r f V r I certify thot in the performance of the work for which this f permit is issued, I shall not employ any person.in any manner so as to become subject to the Workers'Compensation Laws. BOILER, BTU r , APPROVALS DATE INSPECTOR'S SIGNATURE Date. Applicant COMPRESSOR, BTU ROUGH 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 deem- ed revoked. � FURNACE: FAU GRAVITY � , LICENSED CONTRACTORS DECLARATION FLOOR /!??!t%f.i.< BTU 1,� 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 o and Professions Code,and my,license is in full force and effect. a License Number - Lic. Class Contractor ..l >1 �e'i' t.ril ✓ cite d I am exempt under Sec. � Plan check fee B.&P.C. for this reason. 7477;_Date: PERMIT ISSUING FEE $ 3 / 1 TOTAL FEE ) J Signature ��` I•'t...r ' /'• 0"71r�., .} OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT a I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and. NAME f r't1J Professions Code): p� ❑ I, as owner of the property, or .my employees with ADDRESS f ! �r7 !- A A A fTy • wages os their sole compensation,will do the work and i the structure is not intended or offered for sale(Section CITY ( 1p, �„ �✓;J TEL. NO. /r Y L/l/V 1/1 7044, Business and Professions Code). ❑ I, as owner of the property, am exclusively contracting OWNER with licensed contractors to construct the project (Sec- MAIL f% t tion 7044, Business and Professions Code). ADDRESS f {;! x/ 1t CONSTRUCTION LENDING AGENCY CITY. .f^` "t 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.). S / Lender's Name ADDRESS —jl.l�� E_•_. /f G)r t ��'•f; -f.r � , %� / CITY �I f '%► .. TEL. NO. r raj,. y rj..}^ Lender's Address x STATE1 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 . upon th above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ©s