HomeMy Public PortalAbout10938 FREER ST_Mechanical__ ! V1O EFeB 11ON �
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APPLICATION FOR PERMIT LIME GREEN
I renby-ettlrm•tpgx I J�aJa a osrttflcete of consent to to self Insure, �C ,
or a csr1Mcate of Workers Compeneatlon Inaurance,.or a oertlfied HEATING-VENTILATING-AIR CIONDITIONING
oopy,thereef(breo.3800 Lab.C.) IJ
Poiscy No. Corrp" COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
CerHthd copy Is hereby furnished.
❑ Is filed with the comityidlrp buih pectbn FOR APPLICANT TO FILL IN AmED&B /o 4 3 D 8�/• S
(PRRrT OR TYPE ONLY}
Date rtLOCALITY e /e Cry
No. TYPE of APPLIANCE OR EOUIPAtBIT +�
CERTIFICATE OF ETMPTION FROM WORKERS' CROSS ST. .San 64 ,1 v
COMPENSATION tNBURANCE AB9 RPTION UNIT BTU
(This section need.nbt be completed tt the fork Inroiwd by the ABSEWOR
MAP BOOK d o+ / 7^ PAGE" PARCEL �p
permtt b for one hundred dollar(8100)-or lose.) AIR HANDLING UNIT CFM '
DeTncT kia rs+ocBy
I cdrUty that In the performance of the work for whloh this.perrhft
is Issued, I shall not employ any person In any manner so as to BOILETt,BTU
beoome subject to The Workers'Compensation Laws.
COMPRESSOR BTU
ArraovAis usre saffirorn so+nTuM.
Dete APpkrn VENT LATION SYSTEW
NOTICE TO APPLICANT: If, after making this Certlfloate of R(XJGH
Exemption,you should become subject to the Workers'ComperamilonEVAPORATIVE COOLER
provlslpne of the Labor Code, you must forthwith oomply with such. FINAL
provisions or this perm[t the][be deemed revoked. FURNACE: FAU GRAVITY1.50
LICENSED
O98 DECLARATION FLOOR Bre VALIDATIO ITEM I hereby affirm that I am licensed under provisions of Chapter B HEATER ED SUSPENDUNIT 1 ITU w7
(commencing with 8eatton,7000) of Division 3.of the Business and WALL w�
Professions Code,and my Iloense is to full force and effeoL / TOTAL 31 - 50
CHECK 31.50
Boone Nurnber LkL Class
MWE Bo �
Contraotor Deis $
❑. I am exempt under Sao. Plan check fee 000.-{]041 7/ 8/96 OC
& P.C.for treason PERMIT ISSUING FEE `, �D 7296 1 RM 3:35 Q
Me
Die: TOTAL.FEE /
BLI1LDl7�DI LAFIATK3N PLAN C CI<APPLICA T N
OWNER
z
I hereby affirm-that I am exempt from the Contractor's License Law NAME '
fqr the following reason (8oation 7031.5, Business and Professions
Codi): ADL)HE88
ElI, as owner of the property, or my employees with wages
as their sole compensation, will do the work and the CITY TEL NO.
structure Is not Intended or off9rgd for sale (8ectlon 7044, nn
Business and Professions Code).
I, Re,owner of the property, am exclusively oontracting NAIL 1
with licensed oontractore to construct the project (Seo- ADDRESS
tion 7044, Business and Professions Code). CIT1 /4 �),'�(�'/��
IO
'CONSTRUCTN LENDING AGENCY
IHereby affirm that therb le a construction lending a�ency for ,
the n permit a Issued
porformanoe of the work.for wh.loh this-
(8ec.3097,Gtr.C.).
ADDRESS . . .
Lenders Name
CITY TEL_NO.
LerKWa Address STATE LIC.
I oertffy that I have'reed this application and state that the above LICENSE NO. CLAM
Hormarion Is correct I agree to comply with all County ordlnences
and Stade laws retaUng to bullding corutrt cdon,and hereby au&"tze
repreaentativee of this County to enter upon the above-mentioned
Props for Inspection purpoaee. SFE REVE11:19E FOR E(KANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUMAS ME 0505 9702200001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAIP BUILDING ADDRESS:
TR: 11497 LT: 2 BL: .001 10938 FREER ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803342
NEAREST CROSS STREET: FARAGO
85.74-009-965.' 01 PERMIT ISSUANCE FEE27.75 THOMAS PAGE: 597 GRIDd D3 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 1.00 COK 27.00
08 FURNACE/HEATER <100 1.00 UNI 27.00 �SMM ON: PROCE99ED BY: PLAN BY: EXPIRES ON:
30 AIR INLETS/OUTLETS 13.00 LINI 56.55 02/20/97 TC 02/20/98
41 VENTILATION FAN 1.00 FAN 15.90
TOTAL FEES 154.20
DECEMVIRALt SUSIE S
10938 FREER 8T
TEMP 917803542 NEW HEATING AND AIR COMO. OSTEN'
APPLICANT: TEL. NO:
A L R HEATING i AIR COND. (818) 547-5327—
SPECIAL CONDIT
.� LE
APPROVALS UA I t: Lmbwn'r5ff MW.
A L R HEATING i AIR COND. (818) 547-4327—
1471 E. CHEVY CHASE DR. IPB LIC. NO
GLENDALE, CA 91206.-. 667414 C20 ,� �� � COMBUSTION AIR OPENIN�
ARCHITECT OR ENGINEER: TEL. NO
LIC, NO:
f IItTMMMTAT
REMM DETECTION DEVICES
40I11 / 7
REPORT ID: DPR264 ROUTE TO: BSO508,