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Home My Public Portal About5624 HALLOWELL AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0501100001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 12392 LT: 19 BL: .001 5624 HALLOWELL AV FEE DESCRIPTION: QUANTITY; UOM: AMOUNT: ARCD CA 910078419 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 8586-013-025 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: 63 LOCALITY: TEMPLE CITY, C 41 VENTILATION FAN 1.00 FAN 15.75 TENANT: 47 ALTER EXIST DUCT.SYS 1.00 SYS 27.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 70.50 01/10/05 JK 07/09/05 OWNER: TEL. NO: f L D/1 FINAL BY: CODE: NASSAR, CHARBEL (626) 447-9481- 5624 HALLOWELL AV ` L/ ARCD 910078419 DESCRIPTION Of WORK ALTERATION EXIST DUCT SYSTEM. APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO FAU/WALL FURNACE COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK LIC. NO: AC/COMPRESSOR THERMOSTAT FIRE DAMPERS SMOKE DETECTION DEVICES COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO: BS0508 WORKER'S COMPENSATION DECLARATION 20-0046 DPW 9/89 APPLICATION FOR PERMIT I hNreby affirm that I76A364C.have a certificate of consent to self insure, < �`':,r;"' `•�.�"., or a'ce;tificate of Worker's Compensation Insurance, or.a certified HEATING-VENTILATING-AIR CONDITIONING cgpy thereof(Sec.4800 Lab. C.) Policy No., Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. LLLJJI ❑ Certified copy is hereby furnished. . ❑ Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING department. - - - (PRINT OR TYPE ONLY)- ADDRESS Z Date Applicant. NO. TYPE OF'APPLIANCE OR EQUIPMENT FEE LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS'- NEAREST CROSS ST. COMPENSATION INSURANCE ABSORPTION UNIT,BTU (This section need not be completed if the work involved by the ASSESSOR permit is for one hundred dollars($100)or less.), - AIR HANDLING UNIT,CFM MAP BOOK PAGE PARCEL DISTRICT NO. PROCESSED BY I.certify that in the performance,of the work for which this permit is issued, I shall not employ any person In any manner o as to BOILER,BTU become subject to t e Workers' Compensate n Laws. COMPRESSOR,BTU �) APPROVALS DATE INSPECTOR'S SIGNATURE Date v � 'Applican4 VENTILATION SYSTEM - - . NOTICTO APPLICANT: If, afte makin this ertificate of ROUGH Exempt' n,you should become subject to the Workers' Compensation EVAPORATIVE COOLER provisions of the Labor..Code, you'.Must forthwith comply with such FINAL �� a provisions or this permit shall be revoked: FURNACE: FAU GR ITY r LICENSED CONTRACTORS DECLARATION. FLOOR BTU VALIDATION I hereby affirm that I am licensed under provisions of,Chapter 9 HEATER: SUSPENDED UNIT (commencing with Section 7000),of Division 3 of the Business and WALL Professions Code',and my license is in.full force and effect. �Z v 12 i License Number (� Lic.Class Poo. IL Contractor ate p� G; O ❑ I am exempt under Sec. D- �/ Plan Check f@@ U Cr BAP.C.for this reason PERMIT ISSUING FEE$ i O I-- a_ TOTAL FEE W Signature OWNER-B ILDER DECLARATION PLAN CHECK APPLICANT - (n - z I hereby affirm that I am exempt from the C6ntractor'sz License Law NAME - s for the following reason (Section 7031.5, Business.and Professions ► '-t-? =s Code): - F-1 ADDRESS I, as owner of the property, or my employees with wages tiw°E a as their sole compensation, will do the work and the CITY TEL.NO. i i EM structure is not intended or offered for sale (Section 7044, Business and Professions Code): OWNER / i r_t�€r1L 5 F m 00 ❑ I, as owner of the property, am exclusively contracting MAILr7 _4 ' s F 4 with licensed contractors to construc4,the project (Sec- ADDRESS ✓ ��Or�c� tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY / �` TEL,`NO. yG� CHANGE hereby affirm that there is a construction lending agency for CONTRACTOR theperformance of the work for which this permit Is issued ll ► �. ! (Sec.3097, Civ.C.). a It u t li ed L ADDRESS / S / In v 7 _., Lender's Name �J�f 3715. 1 '- CITY TEL.NO.7'JV 'f7Gi ! (V .. . Lender's Address STATE LIC. 11 I certify that I have read this application and state that the above LICENSE NO. 7(p CLASS -' information is correct. I agree to comply with all County ordinances and State laws relating to building construction,and hereby authorize ' 7. represetatives of this County to enter upon the above en'oned proper for inspec o purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE APPLICANT OR AGENT DA