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Home My Public Portal About5941 IVAR AVE_Mechanical__ 76 A364- CE 818- 6-73 APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONOITIONING COUNTY OF LOS ANGELES BUILDING 5941 N. Ivar DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY NEAREST Tpmplp City CROSS ST. Rosemead - Hermosa FOR APPLICANT TO FILL IN OWNER (PRINT OR TYPE ONLY) MAI L N.O. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS 5941 N. Ivar 1 ABSORPTION UNIT, BTU 3:6,;000 CITY Temple City TEL. NO. '285-8313 UU AIR HANDLING UNIT, CFM - CONTRACTOR E. L. 'Pa ne Company ADDRESS BOILER, BTU 166 W Live Oak Ave CITY TEL. NO. ,Arcadia 793-1131 COMPRESSOR, BTU STATE LIC. LICENSE NO. CLASS VENTILATION SYSTEM DISTRICT.NO. GROUP ZONE PR CESSED BY EVAPORATIVE COOLER 3- I FURNACE: FAUGRAVITY INSPECTION RECORD FLOOR BTU HEATER: SUSPENDED—UNIT— WALL— C:) US LENDED UNIT_ - U O H U W N Z Plan check fee 27% of above. See reverse. PERmI'1 ISSUING FEE 8 s 00 TOTAL FEE PLAN CHECK APPLICANT NAME ADDRESS CITY TEL.NO. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCESAND LAWS REGULATING HEATING, VENT[- APPROVALS DATE INSPECTOR'S SIGNATURE LATING,'AIR CONDITIONING. ROUGH I HEREBY CERTIFY THAT I AM�NOT ACTING IN VIOLATION OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND FESSIONA q FINAL CODE OF THE STATE OF/'P, OR NI A. ' SIGNATURE PERMIT VALIDATION K. M.O. CASH OF PERMITT "IJ5�— PLAN CHECK VALIDATION CK, o CASH 6 8 8r,iUf 24..'4.1 U $.0 0 ars SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 76r A384 -t 818 - 9-71 �APICATION4F ERMIT HEATING - VENTILATING - AIR COHOITIOHING COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY NEAR EST CROSS ST. FOR APPLICANT TO FILL IN OWNER (PRINT OR TYPE ONLY) MAIL NO. TYPEOFAPPLIANCE OR EQUIPMENT FEE ADDRESS CITY TEL. NO. ABSORPTION UNIT, BTU _ CONTRACTOR AIR HANDLING UNIT, CFM ADDRESS BOILER, BTU CITY /�4jF32EL. NO. f COMPRESSOR, BTU STATELICE SE NO 6/.2 CLASSU VENTILATION SYSTEM DISTRICT NO. GROUP ONE P CESSED BY EVAPORATIVE COOLER y ( a FURNACE: FAU GR TY U J FLOOR TU INSPECTION RECORD HEATER: SUSPENDED-'FUNIT_ � WALL v w C/ • Z Plan check fee 25% of above. See reverse. PERkIIT ISSUING FEE 8 3 00 TOTAL FEE PLAN CHECK APPLICANT NAME ADDRESS CITY TEL.NO. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE LATING, AIR CONDITIONING. ROUGH I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION e� OF CHAPTER 9, DIVISION 3,4F THE BUSINESS A D PROFESSIONAL FINAL ��7' -27 CODE OF THE STATE OF IFORN SIGNATURE PERMIT VALIDATION CK. M.O. CASH OF PERMITTEE PLAN CHECK VALIDATION CK. M.0. CASH NAV.. 15 y D SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ' L` 76 A364- CE 818-1/75 Yyj APPLICA YON FOR PERMtI HEATING - VENTILATING - AIR-CONDITIONING AJ COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS ✓ V �--� BUILDING AND SAFETY .DIVISION LOCALITY NEAREST b CROSS ST. FOR APPLICANT TO FILL IN owNERILII— D1 - (PRINT OR TYPE,ONLY) . - QOn NO. TYPE&SIZE OF.EQUIPMENT, `. ., FEE MAIL - _ SEE BACK OF APPLICATION ADDRESS CITY �� TEL. > FORCE AIR FURNACE_BTU CONTRACTOR ! r COMPRESSOR, BTU ADDRESS VENTILATION FAN CITY 1 TEL. N r� LIST ALL OTHERS BELOW STATE LICEO� CLASS NSE NO.. DIST RICT nGIOUP ONE OCESS ED BY INSPECTION RECORD } a o U O U W d Plan check fee. See reverse: z PEH1'll'I' [SSI,'15C:. F1�:.1; c 9 00 PLAN C CK APPLICANT NAME ADDRESS �f CIT fy TEL. �p/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VE N11- APPROVALS DATE. INSPECTOR'S SIGNATURE LATING, AIR CONDITIONING . ROUGH I HEREBY CERTIF AT I AM NOT ACTING IN'VI L ION .. OF CHAPTER 9,.,DIVIS 3, OF THE BUSI SS AND PROF S NAL„ NAL 1 CODE OF THE STATE CA ORNI 17 SIGNATURE _ PERMIT VALIDATION - CK, M,O. CASH OF PERMITTE PLAN CHECK VALIDATION CK. M.O. CASH p,? �n p pp , WORKER'S I have a certificate of consent to r 76A364C DPW 9/89 AIf�I�UCATO®OYl FOR PERNT I hereby affirm that I have a certificate of consent to seer insure, or a-certificate of Worker's Compensation Insurance, or•a certified HEATING -VENTILATING-AIR CONDITIONING �V1 copy ther ( c.3800 Lab.C.) Policy N�—�Company � ' �l COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. �❑lCertified copy is hereby furnished. LIQ, Certi ied copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING dep mgh t. (PRINT OR TYPE ONLY)' y�r Applicant LOCALITY r/ ( / NO. TYPE OF APPLIANCE OR EQUIPMENT FEE �'..•+ CERTIFICATE OF EXEMPTION FROM.WORKERS' NEAREST CROSS COMPENSATION INSURANCE . ' ABSORPTION UNIT,BTU ASSESSOR OR (This section need•not be completed if the work involved by the MAP BOOK PAGE. PARCEL. permit is for one hundred dollars($100)or less.),. rAIR HANDLING UNIT,CFM " DISTRICT NO. PROCESSED BY , I certify'that in the'..performance of the work for which this permit is issued, I shall not employ any person in any manner,so as to BOILER,BTU ,become subject to the Workers'Compensation Laws. O� 1�G COMPRESSOR,BTU - " APPROVALS DATE INSPECTOR'S SIGNATURE Date " Applicants VENTILATION SYSTEM - NOTICE TO APPLICANT: If,,after making this Certificate of ROUGH Exemption,you should become subject to,the Workers'Compensation EVAPORATIVE COOLER provisions of the Labor Code, you must forthwith comply with such FINAL M124- provisions or this permit shall be deemed revoked. FURNACE: FAU 'GRAVITY LICENSED CONTRACTORS'DECL'ARATIONFLOOR' BTU O QcVALIDATION Thereby".affirm that I am licensed under,provisions of Chapter 9 SUSPENDED UNIT '.(commencing with Section.7000) of Division 3 Of the Business and HEATER: WALL - Professions Code,anis my license is in full force and effect: Y. License Number ' � � LiaIL 1.Contractor ' 4a"te 0 ❑.'` I am exempt under Sec. Plan cheek fee ' BAP.C.for this reason PERMIT ISSUING FEE$ " Date: TOTAL FEE OW.. Signature co OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT Z I hereby affirm that I am exempt from the Contractor's License Law NAME D "for the following reason (Section 7031.5, Business and Professions f ADDRESS - Ys'•._.I °z I, as owner of:the property, or my employees with wages ' as their safe compensation, will do the work and the CITY TEL.NO. -- - - structure is not intended or offered for sale (Section 7044, o I' EM' Business and Professions Code). OWNER I, as.owner of the property,.am exclusively,contractingI I1°HL X32 - 0y MAIL with licensed contractors to construct the project (Sec- ADDRESS �La t J5 tion 7044, Business and Professions Code). n CONSTRUCTION LENDING AGENCY CITY" TEL.NO. ;j} I hereby affirm that there is a construction lending agency for �g the performance of,the.work for which this permit Is issued CONTRACTOR / / _ 1 l (Sec.3097,Civ.C.). �•/ s - 1. It ADDRESS % /P. ' Lender's Name JWP/ t 4 f(i CITY I -TEL.NO. " Lender's Address STATE LIC. certify that I have read this applicationand state that the above .LICENSE NO. CLASS 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 above-mentioned property to ins tion purposes. .,' SEE REVERSE,FOR EXPLANATORY LANGUAGE A�/,54V SIGNATU OF'PPL AN OR AGENT DAT