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HomeMy Public PortalAbout5337 GLICKMAN AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1202060007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I ITR: 10558 UN: .004 I J 5337 GLICKMAN AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803330 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LANDSEER 18585-002-019 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl 1 130 AIR INLETS/OUTLETS 2.00 UNI 8.70 I 1 (TENANT: 147 ALTER EXIST DUCT SYS 1.00 SYS 27.00 JISSUED ON: PROCESSED BY: PLAN BY: J 1 1 TOTAL FEES 63.50 102/06/12 SR 1 DOWNER: TEL. NO: J IFINAL DATE FIN Y: CODE: JAL, ADRIAN (626) 476-5999- J 1 15337 GLICKMAN AVE. J I I ITEMPLE CITY CA 91780 1 IDESCRliPTION OF WORK J I I (ALTERATION OF EXIST DUCT SYSTEM AND ADD 2 AIR INLETS I JAPPLICANT: TEL. NO: J ' I ILIU, MICHAEL (213) 928-7746- J 12550 W. MAIN STREET J ISPECIAL CONDITIONS: 1ALHAMBRA CA 91801 J J I ICONTRACTOR: TEL. NO: J APPROVALS DATE INSPECTOR SIGNATURE IPALACE CONSTRUCTION INC. (626) 552-1655- 1 1 117078 COLIMA ROAD #317 LIC. NO J IFAU/WALL FURNACE I J IHACIENDA HEIGHTS, CA 91745 383572B J 1 1-1 1 1COM13USTION AIR OPENINGS I J I (ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK ILAM, GARY (626) 588-8615- 1 1 12550 W. MAIN ST., #211 LIC. NO: I JAC/COMPRESSOR I 1 JALHAMBRA, CA 91801 NONE J I 1 1 I J ITHERMOSTAT I I I . IFIRE DAMPERS 1 I I I 1 ISMOKE DETECTION DEVICES . (COMMERCIAL HOOD J J I I I J I I I I I J I I I I I I I J I I I I I I I I I I I I I I I I I I I I I 1 J* ADDITIONAL DATA ON FILE I I I IREPORT ID: DPR264 ROUTE TO: BS0508 I I J 1 I I I I I I WORKERS' COMPENSATION DECLARATION APPLICATION FOR PERMIT 1 hereby affirm that I have a c„�'icaTe ctf consent To self , insure, or cr certificate=of Wo—grs' Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING 'orr-a certified copy thereof (Sec. 3800, Lab. C.) 76A364C 20-0046 DPW 9/88 Policy F-1 Certified copy is hereby furnished.No. Company COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ Certified copy is filed with the county building inspec- FOR APPLICANTITO FILL IN BUILDING / /� tion department. ADDRESS ,, � C (PRINT OR TYPE ONLY) kiplal-1i4 v - Date Applicant LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST. �l��Za (This section need not be completed if the work involved by ABSORPTION UNIT, BTU DISTRICT�NO. SED 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 00 permit is issued, I shall not employ any person in any manner SO a5 10 become subject to The Workers' Compensation Laws. I BOILER, BTU -�j 9Y `�/` APPROVALS DATE IN CTOR'S SIGNATURE � C� COMPRESSOR, BTU s 1 Y 0 0 ROUGH t)(Xc G 3 � � Exemption, y I 6 Date Applicant— NOTICE NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL K you should become subject to the Workers' / Compensation provisions of the Labor Code,-you must forth- EVAPORATIVE COOLER V I A O with comply with such provisions or this permit shall be deem- ed revoked. FURNACE: FAU GRAVITY � LICENSED CONTRACTORS DECLARATION FLOOR BTU les1. 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. and Professions Code,and my license is in full force and effect. � Q0� 1 CL CL License Number Lic. Class �( P. rk U Contractor Date Irm ❑ I am exempt under Sec. Plan check fee B.&P.C. for this reason. N PERMIT ISSUING FEE $ Date: m Signature TOTAL FEE ,P OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and NAME Professions Code): ADDRESS •�' ` ❑ I, as owner of the property, or my employees with ^� - wages as their sole compensation,will do the work and H-:=•I aT CITY TEL. NO. The structure is not intended or offered for sale (Section i-1--� o,of j0 7044, Business and Professions Code). OWNER T I, as owner of the property, am exclusively contracting i SEM' with licensed contractors to construct the project (Sec- MAIL r tion 7044, Business and Professions Code). ADDRESS s€6 i A� CONSTRUCTION LENDING AGENCY CITY TEL. NO. ; I hereby affirm that there is a construction lending agency for ® (.•H=•_•+ - TJ the performance of the work for which this permit is issued CONTRACTOR (Sec. 3097, Civ. C.). =' N UL °CO- ADDRESS Lender's Name CITY TEL. NO. f;i 36 E-iiU�<i =`r 19E Lender's Address �_ I certifythat I have read this application and state that the STATE LIC. - . PP 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-tieove-ment' nod properly for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I Signature of Applica Agent' Date ©s