HomeMy Public PortalAbout5109 FARAGO AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1209240029
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
IBK: 251 PG: 37 PC: 1 2 I 5109 FARAGO AV
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803500
(ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
18574-008-057 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, CI
1 102 COMPRSR < 100 KBTU 1.00 COM 27.00
(TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY:
I 130 AIR INLETS/OUTLETS 10.00 UNI 44.00 109/24/12 SR
I 154 NO PERMT $224.70 MIN 342.20 342.20 I
(OWNER: TEL. NO: I TOTAL FEES 468.00 1FINAli ATE FINA BY: CODE:
PANG YEE FU -
I5109 FARAGO AV I II
TEMP 917803500 ID SCR PTION OF WORK
IREPLACEMENT HEATING AND AIR CONDITIONING
APPLICANT: TEL. NO:
ISUNSHINE AIR CONDITIONING INC. *(626) 890-7545-
I8544 SHEA PL ISPECIAL CONDITIONS:
IROSEMEAD CA 91770 I
ICONTRACTOR: TEL. N0: I (APPROVALS D�INSPECTOR SIGNATURE
ISUNSHINE AIR CONDITIONING INC. (626) 890-7545- I I
18544 SHEA PL LIC. NO I IFAU/WALL FURNACE
IROSEMEAD CA 91770 880274C-20 *I I 71T
I I (COMBUSTION AIR OPENINGS
(ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I
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LIC. NO: I 1AC/COMPRESSOR �I I
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ISMOKE DETECTION DEVICES I I I
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I 1* ADDITIONAL DATA ON FILE
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IREPORT ID: DPR264 ROUTE TO: BS0508
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WORKER'S COMPENSATION DECLARATION 20.0046 DPW 9/89
76A364C APPLICATION FOR PERMIT LIME GREEN,
-
I hereby affirm that I 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. 3600 b.C.)
Policy No.�Company 7 �ZfT �� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
❑ Certified copy is hereby furnished.
I� Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING .C
ment. . q .C LOCALITY
(PRINT OR TYPE ONLY) ADDRE
dep
.
Date Applicant G // NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WORT ER7) NEARESTST.
COMPENSATION INSURANCE CROSS
ABSORPTION UNIT,BTU ASSESSOR
(This section need not be completed if the work involved by the MAP BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit C 4
is issued, I shall not employ any person in any manner so as to BOILER,BTU
become subject to the Workers' Compensation Laws. Z pw LJ
49, COMPRESSOR,BTU APPROVALS DATE INSPECTOR'S SIGNATURE
Datepplicant VENTILATION SYSTEM
NOTICE TO APP ICANT: If, after ing this C tificate of ROUGH / �-
Exemption,you should become subject Wthe Workers' ompensation EVAPORATIVE COOLER
provisions of the Labor Code, you must forthwith comply with such FINAL Q�
provisions or this permit shall be deemed revoked. FURNACE: FAU A ITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU 5 1P VALIDATION
I hereby affirm that,I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
(commencing with Sction 7000) of Division 3 of the Business and WALL
Professions Code,and my license is in full force and effect.
h � 0 fa
License Number Lic.Class v�
Contractor " Date o
❑ •I am exempt under Sec. Plan Check fee U
Q
B.&P.C.for this reason PERMIT ISSUING FEE ! O
Date: TOTAL FEE U
W
Signature
nature -
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT CD
Z
Z
I hereby affirm that I am exempt from the Contractor's License Law NAME ONO.for the following season (Section 7031.5, Business and Professions v
Code): ADDRESS g
❑ I, as owner of the property, or my employees with wages ACCT°s
as their sole compensation, will do the work and the CITY TEL.NO. 107 f _�
structure is not intended or offered for sale (Section 7044, "-' °_E-
Business and Professions Code). OWNER �!/ ITEMS 1 i
Lv - lf�liS
I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec- MAIL ADDRESS v S '�/,/� �yw Tn.T
A- 109 - 55
tion 7044, Business and Professions Code). ^1 u r,f tif•ff4°CC
CONSTRUCTION LENDING AGENCY CITY �/ �� TEL.NO. ��Q�d® trdLl�,E�`4rK lt'
I hereby affirm that there is a construction lending agency for CONTRACTOR (R , L•fiMf`147E °II�
the performance of the work for which this permit Is issued /
(Sec:3097,Civ. C.).
ADDRESS '
Lender's Name per' ,y �7 u 1210 I71
CITY ! /c �G4Jrf/,6TEL.NO. S 6, 7 VVit�JfliJ��LrV 1 i All 9 Ci
Lender's Address ✓ 1i1 1 All 7°i
STATE 1� LIC. �I
I certify that I have read this application and state that the above LICENSE NO. CLASS G'a U' •
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 fo inspection oses. n SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATUR F A PLICANT OR AGE DATE