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HomeMy Public PortalAbout10307 KEY WEST ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0201030004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GAL 1D: FEES PAID BUILDING ADDRESS: TR: 36735 LT: 3 10307 KEY WEST ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803477 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HALIFAX 8585-018-067 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY 02 COMPRSR < 100 KBTU 1.00 COM 27.00 TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED N: PROCESSED BY: PLAN B EXPIRES ON: TOTAL FEES 81.75 01/03/02 JK 07/02/02 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: PINNEY ROGER G;DIANA P (626) 442-8122- 10307 KEY WEST TEMPLE CITY DESCRI1:"rION OF WORK REPLACE EXISTING HVAC SYSTEM APPLICANT: TEL. O: ADVANCED AIR SYSTEMS (909) 466-8033- 12745 SUMMIT SPECIAL CONDITIONS: RANCHO CUCAMONGA CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ADVANCED AIR STSTEMS (909) 466-8033- 12745 SUMMIT AVE LIC. NO AWA L FURNACE RANCHO CUCAMONGA, CA 91739 481200C-20 COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. NO: DUCT WOR LIC. NO: AC/COMPRESSOR THERMOSTAT FIRE DAMPERS SMOKE DETECTIO DEVICES COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO: BS0508 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT I hereby affi-rm that I have a certificate of consent to self insure, or a certificate of Workers' Compehsation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified copy thereof (Sec. 3800, Lab. C.) CE-81C �. CE 618(REV. 10/81) Pol � icy No. Z Company k EvIAL _ Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDIN AFETY -2 Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING tion department. ��-.�� n (/,,��,, (PRINT OR TYPE ONLY) ADDRESS Date Applicant 651-, Alk C"orUdN<ON LOCALITY � /e T O. TYPE OF APPLIANCE OR EQUIPMENT FEE r l CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST. /4 BY (This section need not be completed if the wor 'nvolved by ABSORPTION UNIT, BTU DISTRICT NO. PROCESS the permit is for one hundred dollars($100 r less.) AIR HANDLING UNIT,CFM certify that in the performance of th ork for which this permit is issued, I shall not employ a person in any manner so as to become subject to the W ers'Compensation Laws. BOILER, BTU APPROVALS DATE I P CTOR'S SIGNATURE COMPRESSOR, BTU 000 ROUGH Date AIcanT 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 VALIDATION with comply with such provisions or this permit shall be deemed revoked. FURNACE: FAU_�GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU 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 mylicenseis in full force and effect. License Number J0� I Lic. Class C-;L6 , Contractor r Date 0Z 2❑ lJ�r N JI (�— `\ V tU I am exempt under Sec. LU Plan check fee H B.&P.C. for this reason Date: PERMIT ISSUING FEE $ Signature S e TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt fromi ;23267A Contractor's License Law for The following reason (Sectio 7031.5, Business and NAME , Professions Code): ❑ I, as owner of/ProessionscCocle). or my employees with ADDRESS # 0 0 0 0 0 8 wages as their snsation,will do The work and o 0 4 4 5 0 the structure is nd or offered for sale(Section CITY TEL. NO. 7044, Business aions Code). o 00445030 OWNER❑ I, as owner of th , am.exclusively contractingwith licensed coo construct the project (Sec- MAIL O 24=85 tion 7044, Businfessions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY TEL. NO.�d 0 336 1 hereby affirm that there is a construction lending agency for the performance of.the work for which this permit is issued CONTRACTOR O / (Sec. 3097, Civ. C.). ADDRESS �6 /I / ed Y• u Lender's Name �v CITY TEL. NO. Lender's Address t I certifythat I have read this application and state that the STATE ©J ' LIC. C) pp LICENSE NO. J CLASS 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 above-mentio property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote