HomeMy Public PortalAbout6153 IVAR AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0504060005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID - BUILDING ADDRESS:
TR: 5904 LT: 21 UN: .002 6153 IVAR AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801524
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5386-010-066 01 PERMIT ISSUANCE_FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES N:
30 AIR INLETS/OUTLETS 5.00 UNI 21.75 04/06/05 JK 10/03/05
41 VENTILATION FAN 1.00 FAN 15.75
OWNER: TEL. NO: TOTAL FEES 119.25 FINAL DATE FINAL BY: . E:
CHEN, JOHNNY/KATHY (626) 291-2228-
6153 IVAR AV �-
TEMP 917801524 DESCRIPTION OF WORK
INSTALL AIR CONDITIONING & HEATING SYSTEM
APPLICANT: TEL. NO:
TAO (626) 458-8307-
317 W. LAS TUNAS SPECIAL CONDITIONS:
SAN GABRIEL
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
ALEX TAO AND ASSOCIATES (626) 458-8302-
317 W. LAS TUNAS DR., #208 LIC. NO FAU/WALL FURNACE
_
SAN GABRIEL, CA 91776 744151B
COMBUSTION AIR OPENINGS >
ARCHITECT OR ENGINEER: TEL. O: DUCT WORK - -
LIC. NO: AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICE
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: OS0508
ORKERS"COMPENSATION,DECLARATION
byyaffirm that I have a certificate of consent to self ll"L5 1r=�1 II I1V FOR. lf"15 tl`V'U
re, ora �ertific!teeof Workers' Compensation Insurance, ,eAabnc HEATING VENTILATING - AIR CONDITI0id14�G
a certified copy Thereof (Sec. 3800, Lab. C.,)
CE-818(REV. 10/81) -
Policy No.r�a070q-Company lP -rued` .
Certified copy is hereby furnished.. "COUNTY OF.LOS ANGELES BUILDING AND SAFETY
Certified copy Js fled'.with The county building inspec= FOR APPLICANT TO FILL IN = -: BUILDING ��
' Tion department. (PRINT OR TYPE ONLY) ADDRESS V
Date -Applicant , LOCALITY Ck t
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE �`�
CERTIFICATE OF'EXEMPTION OM WORKERS' NEAREST
_ - - .._.
COMPENSATION INSURANCE
ABSORPTION UNIT BTU DISTRICT NO ROCS
CROSS ST.
' (This section need not be completed ifthe'work involved by _ ..__:- •
the permit is for one hundred dollars ($100)or leis.) T v
D P SSED BY
p A111 R HANDLING UNIT, CFM 5.6
• t certify that in the erformance'of the work for which this ___.
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 INSPECT O 5 NATURE
-.� -- ,
Date Applicant COMPRESSOR, BTU "0 ROUGH
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 VALIDATIO
with comply with such provisions, or. this permit shall be
deemed revoked. FURNACE: FA
LICENSED CONTRACTORS'DECLARATION FLOOR U
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.Professons Code,and my license is in full force and effect. CL
'License Number-302RUs Lic. Class C) t7
Contractor' d4i2d Date 2— 0
❑'' 1,am exempt under Sec. _ `U
Plan check fee d
B.&P.C. for this reason -
Z
- PERMIT ISSUING FEE $ Q'
Date:
TOTAL FEES :I ,o 3 Q 5 O,.
Signature
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); _
❑ I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section CITY TEL. NO.
7044, Business and Professions Code). Q
OWNERDo KA, l_
E] 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 CITYTEL NO' Q
I hereby affirm that there is a construction lending agency for. '` IP_
the performance of the work for which this permit-is issued CONTRACTOR"
.(Sec 3097 Civ. C.).
ADDRESS
Lend'er's Name rt-5�1
CITY t \ TEL: NO. 1(, r!
Lender's Address
STATE 2 /n LIC...
I certify•That I have read this application and state that the LICENSE Na.3oa U 6 S CLASS -
above'iriformation is correct. i agree to comply with all County
ordinances and State laws relating to building construction, •'t
and hereby outhorize representatives of this County to enter
upon the above-mentioned property for.inspection purposes. SEE REVERSE.FOR EXPLANATO,RY.LANGUAGE . .
Signature of Applicant or Agent Date- - - - - --