HomeMy Public PortalAbout9441 GARIBALDI AVE_Mechanical__ CPUNTY OF LOS ANGELES TEMPLE CITY # D508 • . MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TLNAS ME 05089706110018
BULLDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: �Lhb PAW BUILDING ADDRESS;
ON.FILE 9441 GARIBALDI AV
FEE DESCRIPTION: QUANTITY: UOM: ANOINT: TEMP CA 917601648
NEAREST CROSS STREET:. .
5385-008-020 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY
30 AIR INLETS/OUTLETS 1.00 UNI 4.35
TOTAL FEES 32.10 ISSUED
. PROCESSED BY: PLAN BY: B(PlKtb LM:
06/11/97TC - 06/11
OWNER: TEL. NO: FIKkL DAT F IN.AL IT .
SCHOLVINCK FEDOR A;CAROLYN A (818) 309-0320-
9441 GARIBALDI AV
TEMP 917801648
EXTEND ONE DUCT FROM EXISTING SYSTEM
APPLICANT: TEL. NO:
SAME AS OWNER
SP EC 01 MVITIONS:
LEo
CONTRACTOR: TEL. NC: APPROVALS I t: I N
SAME AS OWNER
LIC. NO + r' `� w�
i"
-�
FAU/WALL FURNACE
COMBUST I ON AIR OPENINQS
)R ENGINEER: TEL. NO:
DUCT W�
LIC. NO:
i
FIRE. DAMPERS .
c: . .
REPORT ID: DPR264 ROUTE TO: BS0508
WORKER'S COI'' "°"° ''°" 2G°°"°DPW°'a° APPLICATION FOR PERMIT LIME GREEN
I hfrebyLafflan thil I have a oerttflcate of consent to self Insure,
or a oertttloate of Workers Compensation Insurance,or a certHled HEATING-VENTILATING-AIR CONDITIONING
o-o thereof( 3800 Lab.C.) 1
COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
CerdW copy is hereby furmhamd.
❑ certHied copy to filed wtth the cos trrp.ouon FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) ��
Darn LOCALf1Y /`
NO. TYPE OF APPLIANCE OR EQUIPMENT FEF
CERTIFICATE OF EXEMPTION NEAREST _
C0068 ST.
COMPENSATFON.INSURANCF AB90RPTION UNIT BTU
(This section need not be oompleted if the work Invotved by the MAP BOCK( PAGE PARCEL
permit Is for Pm hundred dollars(!1100)or Fess.) AIR HANDLING UNIT CFM
orrwoT Na ar
I ceriNy that In the performance of the,work for which this permit
Is Issued, I shall not employ any person In any manner so an to SOLER,BTU
beoome subject to the,Workers'Compenbatton Laws.
COMBTU
APPFKNAu an VOWEL ars 8WNAnra
DataAPP�nt VENTILATION SYSTEM
NOTICE TO APPLICANT: It, after making this Certificate of ROUGH
Exemption,you should become eubleot to the Workers'Cbmpersation EVAPORATIVE COOLER FINAL
provisions of the Labor Code, you must forthwith comply with such
provisions or this permft shall be deemed revoked. FURNACE FAU
Imam ACTORS DECLARATION FLOOR G 6 O VALIDATION
I hereby affirm that I am licensed under provisions of Chapter 8 SUSPENDED UNIT
(commencing with Section 7000) of Division 3 of the Business and HEATEFL WAI i
Professions Code,and my license Is In lull force and efteot
$
Lkxwm Number Lb.ck m ► ACCT.r
� r
2330380.508
i am exempt under Seo. Plan check fee 1 ITEM Q
B.SP.C.for this reason PERMIT ISSUING FEE i
Q TOTAL 80 o 50E
Dau TOTAL FEE a QCHECK OW
50
rs •�
OWMER-BUILDER DECLARATION PLANCi CHECK APPLI(AN f
1 hereby aHlrm that I am exempt trom the Contractor's License Law NAME
for the following reason (Seotlon 7031.6, Business and Professions ' 1 10/ 3/99-
Code): ADDRESS
El1. as owner of the property, or my employees with wages 11��V7
as their sole compensation, will do the work and the CITY TEL NO.
structure Is not Intend&¢or offered for sale (8ectlorr 7044,
BusIrw es and Professions Code). OWNER ��k0`
❑ I, as owner of the property, am exclusively contracting
with Ilbensed oontraotors to construct the project (Seo- AMIESS
tion 7044, Business and Professions Code). CCITY 119�-Vo
CONSTRUCTION LENDING AGENCY ((y
I hereby affirm that there Is ■ construction lending agency for
the performance of the work for-whloh this permit Is Issued CONTRACT ,
(Sec,3097,Cly.C.).
ADDRESS
F5
Lenders Name
CITY TEL NO
Lenders Address STATE / LIC.
I certffy that I have read thl"application and state that the above Lk �
NO. L Orag CLA88
information Is correct I agree to compty with all County ordlnenoee
and State taw"relating to bulking contatructlort,and hereby euthortze
repreee this County to enter upon the above-mentioned
props fo Ins on p SEE REVERSE FOR EXPLANATORY LANGUAGE