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HomeMy Public PortalAbout4943 KAUFFMAN AVE_Mechanical__ 76A364E(qE-818(1);9/77 A PPA ICSTI®IU FOR PERMIT HEATING -.VENTILATING YVP- AIR C®N.®ITI®NING COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN BUILDING (PRINT OR TYPE ONLY) ADDRESS LOCALITY NO. TYPE OF. OR EQUIPMENT FEE • NEAREST Qe CROSS ST. ABSORPTION UNIT,UNIT,BTU OWNER AIR HANDLING UNIT,CFM- MAIL AD DRESS BOILER,BTU CITY 7 f.../, C-/766 /J` TEL.NO. COMPRESSOR,BTU CONTRACTOR VENTILATION SYSTEM ADDRESS v EVAPORATIVE COOLER CITY ..��-- TEL.NO. FURNACE: FAU-GRAV ITY STATE . Ce7L�ASOS`� L FLOOR BTU LICENSE NO. 7' HEATER: SUSPENkt�j UNIT- DISTRICTNO. GROUP ZONE PRO E SED BY WALL >_2�2,-r•/ I ,-�✓ �.� INSPECTION RECORD 16 a O Plan check fee 25%of above. PERMIT ISSUING FEE$ Z TOTAL FEE 7 Q PLAN CHECK APPLICANT' NAME ADDRESS CITY TEL.NO. IHEREBY 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, VENTILATING, AIR CONDITIONING. I HEREBY CE I Y T I AM NOT ACTING I VIOLATION OF APPROVALS DATE SPECTOR'S SIGNATURE CHAPTER 9, DIVISI N F HE BUSIN AND PR ESSIO AL CODE ROUGH Q OF.THE STATE OFC LI O A. �� ✓ -�✓!" SIGNATURE f FINAL OFPERMITTE _J / PLAN CH VALIDATION CK. M.O. cnsH PERMIT VA ID ON cKr M.O. CASH J3iV 1 ?.0 C) ©5 WORKER'S COMPENSATION DECLARATION 20-0046 DPW 9/89 n�p /�p�5� f�p LIME GREEN I herPbyaffi;m that I have a.certificate of consent to self insure, 76A364CQl�lf'L��CA 11 IOIIC1 FOR PER T or a oertficate of Worker's Compensation Insurance, or a certifiedHEATING-VENTILATING-AIR CONDITIONING copy 4,bre.f(Sec.3800 Lab.C.) Policy No Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV: 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). �Am '- Date Applicant LOCALITY . NO. TYPE OF APPLIANCE'OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST CROSS COMPENSATION INSURANCE ABSORPTION UNIT,BTU ASSESSOR (This,section need not be completed if the work.involved by the MAP BOOK PAGE PARCEL permit is for one,hundred dollars($100)or less.) AIR HANDLING UNIT,CFM DISTRICT NO. PROCESSED BY' I;certify thatin'the performance of the work for which this permit is issued, I shall.not employ any person in any manner so as to BOILER,BTU �� become subject to the Workers' Compens' ion Laws COMPRESSOR,BTU 00 Date' A IlCant APPROVALS DATEINSPECTOR'S SIGNATURE _ f?P VENTILATION SYSTEM NOTICE TO APPLICANT: If, afte making this Certificate of ROUGH Exemption,'you should become subject to the=Workers' Compensation EVAPORATIVE COOLER provisions of the Labor Code, you must forthwith comply with such, FINAL provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY _ LICENSED CONTRACTORS DECLARATION FLOOR BTU W,M6 C> VALIDATION I hereby affirm that l am licensed under provisions of Chapter 9 SUSPENDED UNITi- (commencing with Section 7000)'of Division 3 of,the Business and HEATER: WALL Professions Code,and my license is in full force and effect. License Number / (i Lic.Class ` � � I O� D Oe Contractor E'C, Date .' I am exempt.under Sec. Plan Check fee B.&P.C.for this reason PERMIT ISSUING FEE$ / D 'TOTAL FEE DO W IL Signature L-.�2 (n OWNS -BU LDER D CLARA°PION 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 Code): ADDRESS ❑ I, as owner of the property, or my employees with wages -r:- as their sole compensation, will do the work and the CITY :TEL.NO. >_ ,{j;{ structure is not intended or offered for sale (Section 7044, _ ' Business and Professions Code). OWNER I, as owner of the property, am exclusively contracting MAIL c"i f Iwa i_ t with licensed contractors to construct the project (Sec- ;' -ADDRESS E� �(,( � m� /��/, � • tion 7044, Business and Professions Code). j� CHECK zEGoEj1) CONSTRUCTION LENDING AGENCY CITY C TEL NO. — �Tf L� M I hereby affirm that there is a construction lending agency for D �•tt�i.�"'GE �%11.1 the performance of the work for which this permit Is issued ONTRACTOR (Sec.3097,Civ.C.). G . ADDRESS 1V131101_0013 {I�j1;'` [�1}9 j I ier's.Name / G9— CITY TEL.NO. ?O h'W .. .. Cr,.•. .E.,_ f4. i AM 1 Lender's Address STATE LIC rJ certify that I have read this application and state that the-above LICENSE NO. Z7 CLASS 7 3k - 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 for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT - DATE - - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1011020006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 15080 LT: 2 I 1 , 4943 KAUFFMAN AV 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917804248 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LA ROSA 1 18589-017-011 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl 1 102 COMPRSR < 100 KBTU 1.00 COM 27.00 1 (TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: 1 130 AIR INLETS/OUTLETS 12.00 UNI 52.20 111/02/10 SR I I TOTAL FEES 134.00 1 1OWNER: TEL. N0: i - iFG7�� �'1 FZN BY� CODE: (JONES GRIFFITH R JR;BERTHA M (626) 286-4427- I 14943 KAUFFMAN AV 1 I �,J ITEMP 917804248 I IDE IPTI N CF WORK ICHANGE OUT AIR CONDITIONING AND HEATING SYSTEM I 1APPLICANT: TEL. NO: 1 I (JONES, BERTHA (626) 221-8485- 1 I I 1 I I SPECIAL CONDITIONS: &tA ICONTRACTOR: TEL. NO: I jhgPROVAM DATE INSPECTOR SIGNATURE (JONES, BERTHA (626) 221-8485- I I _ 11 14943 KAUFFMAN AVENUE LIC. NO 1 _ _ 1FAU/WALL FURNACE 1 TEMPLE CITY, CA 91780 NONE ICOMBUSTION AIR OPENINGS I i 1ARCHITECT OR ENGINEER: TEL. NO: 1 1DUCT WORK 1 I I 1 LIC. N0: I IAC/COMPRESSOR I1/-4�-1W I I ITHERMOSTAT I 1, I IFIRE DAMPERS I ISMOKE DETECTION DEVICES I I ICOMMERCIAL HOOD 1 1 I I I I I I I 1 I I I I I I I I I I I 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 IREPORT ID: DPR264 ROUTE TO: BS0508 I I I I I I I I I I