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HomeMy Public PortalAbout6241 GOLDEN WEST AVE_Mechanical__ • ri M f• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0902110006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 6241 GOLDEN WEST AV 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801705 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15385-021-012 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl 1 102 COMPRSR < 100 KBTU 1.00 COM 27.00 TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 130 AIR INLETS/OUTLETS 8.00 UNI 34.80 102/11/09 SR 08/10/09 141 VENTILATION FAN 2.00 FAN 31.50 1 1OWNER: TEL. NO: I TOTAL FEES 148.05 IFINALDATE FI AL BY: CODE: 1 ICHEN, CHIN (626) 235-2233- 1 1 1 16241 GOLDEN WEST AV ! I ITEMP 917801705 1 - 1IJESCRfPTION UF WORK 1 (INSTALL AIR CONDITIONING AND HEATING SYSTEM 1APPLICANT: TEL. NO: I I ILIM (213) 210-3979- 1 1 17250 BANDINI BLVD. I ISPECIAL CONDITIONS: 1 ILOS ANGELES CA 90040 1 1 I I I I I I ICONTRACTOR: TEL. NO: I - 1APPROVALS DATE INSPECTOR SIGNATURE 1 SOUTHERN CALIFORNIA CONSTRUCTION (714) 220-7460- 1 1 18611 E. ROLAND ST. LIC. NO FAU/WALL FURNACE IBUENA PARK, CA 90621 862893 B I I ICOMBUSTION AIR OPENINGS 1ARCHITECT OR ENGINEER: TEL. NO: (DUCT WORK IJ C ENGINEERING (213) 210-3979- 1 12155 VERDUGO BLVD #124 LIC. NO: I IAC/COMPRESSOR I/�J✓ 1 IMONTROSE, CA 91020 40597 1 1 v 1 I I (THERMOSTAT 1 I I I I I I IFIRE DAMPERS I I I I I I I I ISMOKE DETECTION DEVICES 1 I I I I I I 1 1 1COMMERCIAL HOOD 1 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 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 IREPORT ID: DPR264 ROUTE TO: BS0508 - I I I I I I WQKERS' COMPENSATION DECLARATION APPLICATION FOR PERMIT '1 hereby 'affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified copy thereof (Sec. 3800, Lab: C.) 76A364C CE-818(REV. 10/81) Policy No. Company 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 ./ n / /,� jT• tion department. (PRINT OR TYPE ONLY) ADDRESS _.e Date Applicant LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST /� Q COMPENSATION INSURANCEABSORPTION UNIT, BTU CROSS ST. GLS DIS (This section need not be completed if the work involved by TRICT NO. PROCESSED BY the permit is for one hundred dollars ($100)or less.) AIR HANDLING UNIT, CFM I certify that in the performance of the work for which.this /l -permit is issued, I shall not employ any person in any manner BOILER, BTU so as to become subject to the Workers'Compensation Laws. / APPROVALS DATE CTOR'S SIGNATU E ���� / COMPRESSOR, BTU / UO ROUGH i Do Applicants _ i _. 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 G VITY 2 y/ LICENSED CONTRACTORS DECLARATION FLOOR BTU . r(,/ S3(5 I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED—UNIT— '(commencing USPENDED UNIT'(commencing with Section 7000) of Division 3 of the Business WALL and Professions Code,and my license is in full force and effect. License NumbeL'?-3--?ll6/Z Lic. Class C ZD , U C I or /071 Date2;/lQ-- ❑ I am exempt under Sec. Plan check fee M B.&P.C. for this reason S PERMIT ISSUING FEE � Dater TOTAL FEE Signature OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT # 0 0 o 0 0 8 1 hereby affirm that I am exempt from the Contractor's License , .1 o.° 3 Q 5,0 Law for the following reason (Section 7031.5, Business and NAME Professions Code): ❑ 1, as owner of the property, or my employees with ADDRESS ° ° ° 3 Q 5 0 wages as their sole compensation,will do the work and. 0210-86 the structure is not intended or offered for sale(Section CITY TEL. NO. 7044, Business and Professions Code). OWNERAi�ei ❑ 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 CONTRACT 3097, Civ. C.). ADDRESS Lender's Name CITY TEL. CQg/� Lender's Address STATE LIC. I certify that I have read this application and state that the LICENSE NO. —3 CLASS Z© 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 the b ve, ;ecinecl property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date