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Home My Public Portal About4942 FIESTA AVE_Mechanical__ pV 76 A361- CE 818-1/75 APPLICATION FOR PERMIT 4�' HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES BUILDING 4C DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY NEAREST CROSS ST. %� C FOR APPLICANT TO FILL IN OWNER ,5' ` (PRINT OR TYPE ONLY) ' MAIL / L- „ J NO TYPE&SIZE OF EQUIPMENT FEE ADDRESS / SEE BACK OF APPLICATION e-1 - O CITY TEL. NO. FORCE AIR FURNACE, BTU CONTRACTOR COMPRESSOR, BTU ADDRESS ��) �V 1r VENTILATION FAN CITY TEL. NO. �.',I;-:%73 LIST ALL OTHERS BELOW STATE /l LIC. LICENSE NO. 77 ( CLASS DISTRICT NO. GROUP ZONE PROCESSED BY C INSPECTION RECORD Y O U O F- U W 0.. N Plan check fee. See reverse. Z PI4:1011'I' ISSL`IVG Ff;l: S PLAN CHECK APPLICANT NAME ADDRESS CITY TEL.NO. 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS �RRECT,��AGREE TO COMPLYWITH ALL ORDINANCES AND LA EGTIN HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE LATING, AIR CONDITIONING. ROUGH I HEREBY CERTIFY AT A ACTING IN IOLATION OF CHAPTER 9, DIVISION 3 TH NESS AND JESSIONAL FINAL �� yJ.�37✓`• CODE OF THE STATE 0 LIFOR SIGNATURE PERMIT VALIDATION CK. M.0. CASH OF PERMITTEE PLAN CHECK VALIDATIONK O. CASH 2 6 I•ER 20 41qu 1 2,0 U --)8 D 1j . - *ORKERS'COMPENSATION DECLARATION I hereby affirm that'I have a certificate of consent to self APPLICATION FOR PERMIT insure, or a certificate of Workers='Compensation Insurance, HEATING - VENTILATING AIR CONDITIONING or a certified copy thereof (Sec. 3800, Lab. C. 76A364C /[� /+ i_ CE-818(REV. 10/81) Policy No. Company o/"oc#_s,4 / 7 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 department. V (PRINT OR TYPE ONLY) ADDRESS t rFJ —A- — Date-'IbIr" Applicant /145—cati � LOCALITY ( NO. TYPE OF APPLIANCE OR EQUIPMENT FEE �••� I CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST �.�� COMPENSATION INSURANCE CROSS ST. D f�f CTL ABSORPTION UNIT, BTU (This section need not be completed if the work involved by DISTRICT NO. PROCESSED BY the permit is for one hundred dollars ($100)or less.) 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 so as to become subject to the Workers'Compensation Laws. BOILER, BTU APPROVALS DATE INSP T R'S SIG ATURE 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 'VALIDATI N 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 t (commencing with Section 7000) of Division 3 of the Business WALLTL and Professions Code,and my license is in full force and effect. +j CL License Number( 22'� Lic. Class Contractor&�9D 9AA pate t , O � 18a3'A I- ❑ u I am exempt under Sec. us Plan check fee ° ° ° 8 B.&P.C. for this reason Date: PERMIT ISSUING FEE $ I - 20.50 o Signature TOTAL FEE S OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT ° o - 21[1505 I hereby affirm that I am exempt from the Contractor's License n� Law for the following reason (Section 7031.5, Business and NAME 6� P , 0 1 9 8 5 Professions Code): ' i ❑ I, as owner of the property, or my employees with ADDRESS G!1 �r Lt G c• /! CITY wages as their sole compensation,will do the work and G J /TT the structure is not intended or offered for sale(Section C C, f� TEL. NO2 vo8• 7044, Business and Professions Code). OWNER I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- MAIL tion 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY 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.). Lender's Name •s ADDRESS / ^L(Z CITY e_q ./ TEL. N Lender's Address �--✓ er' STATE �f 1— LIC. �' G. I certify that I have read this application and state that the LICENSE NO. - CLASS r 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 tX above-mentioned property for in pectio purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of icant or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1106020017 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: I FEES PAID BUILDING ADDRESS: I ITR: 14647 LT: 14 1 I 4942 FIESTA AV 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803816 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 18590-018-005 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl 1 102 COMPRSR < 100 KBTU 1.00 COM 27.00 1 1 (TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 11SSUED ON: PROCESSED BY: PLAN BY: I I 130 AIR INLETS/OUTLETS 10.00 UNI 43.50 106/02/11 SR I 1 I TOTAL FEES 125.30 1 1 (OWNER: TEL. NO: 1 IFINAL DAE FIN Y: CODE: I ICHEN JIMMY S;SUSAN M - I 14942 FIESTA AV I 1 Skl !�A/ 1 (TEMP 917803816 1 1D SCR PT N OF WORK 1 I I IREPLACE EXISTING ROOF TOP A/C AND HEATING SYSTEM 1 I I I I (APPLICANT: TEL. NO: IV. KACHIKIAN, VIGAN (818) 612-5276- I 1 ISPECIAL CONDITIONS: I I I 1 ti (- (CONTRACTOR: TEL. NO: I APPROVALS DATE INSPEC O I ATU E I (PRECISE AIR CONDITIONING SERVICE (818) 240-1737- 1 1 1 15467 SAN FERNANDO RD., WEST LIC. NO I 1FAU/WALL FURNACE I 1 ILOS ANGELES, CA 90039 428900020 I I I I 1 I I ICOMBUSTION AIR OPENINGS I I I I I I i I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 (DUCT WORK I I I I - I 1 11 1 I LIC. NO: I 1AC/COMPRESSOR I 1 1 I I I I I I 1 1 (THERMOSTAT I I I I 1 11 1 1 I (FIRE DAMPERS I I 1 1 I (SMOKE DETECTION DEVICES 1 1 I I I I I I I I (COMMERCIAL HOOD 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 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 I I I I I I I I I I I I I I (REPORT ID: DPR264 ROUTE TO: BS0508 i I I I I I I