HomeMy Public PortalAbout5019 GOLDEN WEST AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY 1 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 970-1 LAS TUU$ ME 0508 0208280012
BUILDING-AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 917$0
PHONE: (626) 285-0488 EKTLEGALL ID: ft" PAID BUILDING ADDRESS::
TR: 14832 LT: 20 5019 GOLDEN WEST.AV
FEt DESI;RIPTION: (YINTITY: UOM: AMOUNT: TEMP CA 917803939
INFMTION N1 ER: NEAREST CROSS STREET: LA ROSA
6589-018-016 01 PERMIT ISSUANCE FEE 2 .75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
02 DoWkSR < 1019 KBTU 1.00 CCI 2 .00
TEMIT T_ 0$ FlRMACE/HEATEER <1DO 1.00 IIN1 27.00 IMJED ON: MESSED BY: PLAN IST: nmT7M
30 AIR INLETS/OUITLETS 7.00'LIN 1 30.45 08/29/02 JK . UJ25/03
41 VENTILATION FAN 1.00• FAN 15.75
TOTAL FEES 127.95F17 .
KOMAI•NELL (626)'287-3217-
5019 GOLDEN WEST AV
TEMP 917803939 DEPQRIP71ON OF
M HAITI FOR ADD
TOIL OLEARY (626) 287-0927-
5823 AGNES SPECIAL CONDITIONS:
TALE CITY
CONT;bk&OR' TEL. DATE INSPTOM 011EARY CONSTRUCTION (626) 287-0927- ; Q5 JMr`
5823 AGNES AVENUE LIC. NO FAU/WALL FURNACE
TEMPLE CITY, CA 91780 489354 B-TCOMBUSTION AIR OPENLNGS
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THMOMAT
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REPORT ID: DPR264 ROUTE TO: B$0508
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WOAIAF--COMPENSATION DECLARATION CEA S 8APPLICATIONC(2 80) FOR r �fl`(IV{I ��
1. �ci�'ny affirm that I have e' certificate of consent to self
'Vinsure,'3r a certificate of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONINGS
a certified copy thereof(Sec. 3800 Lab. C.)IfT
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Police No ('ompany
r
BUILDING AND SAFETY
Certified copy u hereby furnished. COUNTY OF LOS ANGELES '
Certified copy Is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING
de en r
Date Applicant (PRINT OR TYPE ONLY) ADDRESS
LOCALITY � r
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPENSATION INSURANCE NEAREST }
(This section need not be completed if the work involved ABSORPTION UNIT BTU CROSS ST. d
by the permit is for one hundred dollars (2100) or less.) DISTRICT No. PRor8
1 certify that In the performance of the %vork for which this AIR HANDLING UNIT CFM y cc
v
permit Is Issued, I shell not employ any person In any manner i VA 0
w as to become subject to the Workers' Compensation Laws. BOILER BTUFU-
1
APPROVALS DATE iNar R i 61(SNA RE
Date Applicant U W
PP COMPRESSOR BTU ROUGH
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM / Z
Exemption, you should become subject to the Workers' FINAL —
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDTION
wlth comply with such provisions or this permit shall be
deemed revoked. FURNACE: FAU AVITY
LICENSED CONTRACTORS DECLARATION FLOOR+ BTU
I hereby affirm that I am licensed under provislons•of Chapter HEATER: SUSPENDED UNIT
9 (commencing with Section 7000) of Division 3 of the Busl- WALL
near and Professions Code, and my license is in full force and
effect. ��j���
License Numberz Lic.Cla3s-
Contractor,4;"C-7;�,-,n Data
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer Plan check fee 26% of above.
acting In my professional capacity (Section 7051, Bus-
mesa and Professions Code). PERMIT ISSUING FEES ;24 9 a 0 A
Lic.or Reg. No. Date TOTAL FEE' # • • • • S
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT ;I • • 3 Q 5 0
I hereby affirm that I am exempt from- the Contractor's NAME - - 30,506,
License Law for the following reason (Section 7031.5, Busl-
ness Find Professions Coda): ADDRESS 7 0 8♦8 6
1, as owner of the property, will do the work and the r
structure is not Intended or offered for sale (Section CITY TEL. NO.
7044, Business and Professions Code).
Oi, as owner of the property, em exclusively contracting OWNER
with licensed contractors to construct the project MAIL
(Section 7044, Business and Professions Code). ADDRESS
CONSTRUCTION LENDING AGENCY CIT TEL. NO.
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit Is CONTRACTAR41
issued (Sec. 3097,Civ.C.). 4
Lander's Name ADDRESS
Lender's Address CITY EL. NO.
1 certify that I have read this application and state that the STATE l LIC. �p
above Information Is correct. I agree to comply with all County JJCENSN Q. CL C�
ordinances and State laws regulating Heating, Ventilating and
Alr Conditioning, and hereby agthorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter upon the ave-mentioned property for
uspecu pus
Signature of Permittee Data