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HomeMy Public PortalAbout9109 LAS TUNAS DR_Mechanical__ 78 A364 - CE 818 - 9-7' APPLICATION FOR PERMIT - HEATING - VENTILATING - AIR CONDITIONING . COUNTY OF LOS ANGELES' BUILDING 91 L DEPARTMENT OF COUNTY ENGINEER ADDRESS 6 "p� VNp� BUILDING AND SAFETY DIVISION LOCALITY �� C_ NEAREST ! j CROSS ST: / , / /Z' FOR APPLICANT TO FILL IN OWNER C L okA-S (PRINT OR TYPE ONLY) MAIL Ne t—S NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS CITY TEL. NO. ABSORPTION UNIT, BTU CONTRACTOR AIR HANDLING UNIT, CFM ' tcc ADDRESS W BOILER, BTU CITY TEL. NO. COMPRESSOR, BTU STATE LIC. LICENSE NO. CLASS VENTILATION SYSTEM DISTRICT NO. GROUP ;N:E PROCESSED BY EVAPORATIVE COOLER •® � om+ � � 0 FURNACE: FAUGRAVITY INSPECTION RECORD c.3 FLOOR BTU C91 HEATER: SUSPENDED—UNIT— WALL USPENDED UNIT_WALL w k A�,j (n 7- D C)0 Plan check fee 25% of above. See reverse. PERMIT ISSUING FEE S 3 00 TOTAL FEE d PLAN CHECK APPLICANT NAME ADDRESS QENst Pls u-JPS CITY �1f1n�L4 \� TEL.NO. 71067 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION L ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .. LL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE , AIR CONDITIONING. - ROUGHEREBY CERTIFY THAT I AM NOTACTI IN VIOLATIONPTER9, DIVISI N 3, OF THE BUSINESS A D ROFESSIONALFINALFTHE STATE OF ALIFORNIA.TURE C• PERMIT VALIDATION CK. M.0. ' CASH RMITTEE s PLAN CHECK VA (DATION CK. M.O. CASH a SEE BACK OF APPLICATION.FOR COMPLETE FEE SCHEDULE COUNTY ,OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1404240015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I ITR: 5905 LT: 27 1 I 9109 LAS TUNAS DR 1 I - IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801904 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: HART I 15387-016-023 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI I 141 VENTILATION FAN 1.00 FAN 15.80 1 I (TENANT: 147 ALTER EXIST DUCT SYS 1.00 SYS 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: I I - TOTAL FEES 70.60 104/24/14 SR .I 1OWNER: TEL. NO: I FI /C//AL�DATE,/� FINALBY• CODE: IRUIZ, IVAN A (909) 743-9004- 1 I 115805 BUCK POINT LN I 1 I 1 I 115ESCRIPTION OF WORK 1 (ALTERATION OF EXIST DUCT SYSTEM AND VENTILATION FAN I (APPLICANT: TEL. NO: I I 1 IRUIZ, IVAN A (909) 743-9004- I 1 I 115805 BUCK POINT IN 1 ISPECIAL CONDITIONS: 1 I I I I (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE 1 IA Q CONSTRUCTION INC. (951) 545-4607- 1 1 I 115218 SUMMIT AVENUE 300-537 LIC. NO 1 IFAU/WALL FURNACE I I 1 IFONTANA CA 92336 886028 1 1-1 ' I 1 ICOMBUSTION AIR OPENINGS I I 1 (ARCHITECT OR ENGINEER: TEL. NO: IDUCT WORK I I 1 LIC. NO: 1 IAC/COMPRESSOR F I I 1 I 1THERMOSTAT I I 1 I IFIRE DAMPERS I I 1 1 I ISMOKE DETECTION DEVICES I I 1 ICOMMERCIAL HOOD I . I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 IREPORT ID: DPR264 ROUTE TO: BS0508 I 1 I I 76A364C C==�=•, .. CE�,818(REV.6/78) ©� APP.II'CATION'FOR PERMIT" HEATING - VENTILATING AIR CONDITIONING COUNTY OF LOS ANGELES BUILDING;AND SAFETY . FOR APPLICANT TO FILL IN BUILDING J� O .(PRINTORTYPEONLY) ADDRESS -. - LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT' FEE NEAREST • I - CROSS ST-.' all 4 - ABSORPTION UNIT,BTU " - - ` DOWNER , AIR HANDLING UNIT,CFM MAIL - - ADDRESS. .0.... r _ BOILER;BTU _ . CITY r !S i - TEL.N � g�y COMPRESSOR,BTU w 'CONTRACTOR' vAL.'L VENTILATION SYSTEM ADbRESS AV EVAPORATIVE-COOLER ?' - p //-� CITYA, � G1 TEL.NV�-3'0 (1 FURNACE: FAU GRAVITY STATE `_ + LIC.- FLOOR ' BTU- : LICENSE NO: F CLASS C-�' 9- HEATER: SUSPENDEDUNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE WALL ROUGH FINAL 12, 13:1•S. L'/Cr INSPECTION RECORD ®• Plan check fee 25 O'f above. PERMIT ISSUING FEE$. z TOTAL FEE — m PLAN CHECK APPLICANT: PLAN CHECK VALIDATION NAME ADDRESS - CITY TEL.NO. - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND \ /V"n p ' STATE THAT-THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL - 1 716 ORDINANCES 'AND LAWS REGULATING HEATING ATING,- AIR CONDITIONING. .. - #.a o:.a:a 4 1 PERMIT VALIDATION. CHAPTER 9E DIV SBY EONIFY T THEl AM B SINE T AND PROFESSION ROFESSIONTI OF •ODE ',P•_a.a /'�00 OF'THE STATE OF CA NIA. SIGNATURE .' - a O 0 O Q OF PERMITTEE' .. L.�]--7-8• DISTRICT NO., - PROC Y > - •_L.2 •f..G . WORKER'S COMPENSATION,DECLARATION 20-0046 DPW 9/89 I hereby affirm that`I.have a certificate'bf consent to self Insure; 76A364C APPLICATION FOR PERMIT tIME'l., .GREEN or a certificate 0-Worker's_Compensation insurance, or a certified copy th"eremf'(Sec.3806 Lab.C.) HEATING-'VENTILATING'=AIR'CONDITIONING PolicyNo. '' ' Company' ` COUNTY OF LOS ANGELES' DEPT:OF PUBLIC WORKS BUILDING AND SAFETY DIV ❑ . Crhereby furnished. BUILDI- ❑, ?. Certified copy is filed With the county building inspection FOR APPLIINT CANT EToOLFILL IN ' NG + ��' department.- • �. ADDRESS Date .. Applicant. LOCALITY'.NO. � TYPE OF APPLIANCE OR:EQUIPMENT FEE •.,,, CERTIFICATE OF EXEMPTION FROM'WORKERS' CROSS ST.' ,Qt R 1 COMPENSATION INSURANCE ABSORPTION UNIT,BTU This section need not-be-completed if the work involved by the ASSESSOR ( P Y MAP,BOOK q PAGE PARCEL' permit is fdr one hundred dollars($100)or less.) ;AIR HANDLING UNIT,CFMro DISTRICT NO. PROCESSED BY f:certify than in the performance of the work foh'eVhich this permit r b is issued,•I shall not employ any person in any'manner.so as to BOILER,BTU become subject to the Workers'Compensation`Laws. COMPRESSOR,BTU-s"10 -Date' Applican4'`- _ :VENTILATION`SYSTEM lam, ,'APPROVALS'.,.:, A DATE '.; - :-INSPECTOR'S SIGNATURE NOTICE TO APPLICANT: if; after making this Certifi6ate of ROUGH Exemption,..you should become subject to the Workers'Compensation EVAPORATIVE COOLER provisions of.the Labor Code;you,must forthwith.comply with such FINAL provisions or this permit shall be deemed revoked... . FURNACE, FAU GRAVITY ^4 LICENSED CONTRACTORS DECLARATION 'FLOOR BTU ' VALIDATIC$I Ihereby affirm that I am.licensed under provisions of,Chapter 9 SUSPENDED UNIT HEATER: h! (commencing With Section 7000) of Division..3 of the Business and -WALL . Al•�•ToT Professions Code,anti ny license is in full force and effect.. 303 36 J.� License Number Lic.Class 1.ITEMS OTAL 53 90 > Contractor Date' d 53 s 7 V U CHECY ❑ ,l.am exempt under Seo. CHANGE o Plan check fee .00 B.&P.C.for this reason PERMIT ISSUING FEE$ Q n. 11-- Date: _ 2/14 9� ,.a TOTAL FEE- %. �Z� dboo7f con M1ft�1 Signature - PLAN CHECK 'APPLICANT - - YV f-, -' 1 AMID 16�=en OWNER-BUILDER DECLARATION Z I hereby affirm that.l.am.exempt fromAhe Contractor's License taw.- NAME,�� 1 fdr the following reason (Section 7031.5', Business and-Professions �C de): ADDRESS, C.t , '. I, as owner of' property, or my employees with wages- r. as their sole compensation, will do-the work and the CITY TEL.,NYA structure-1s not intended or offered for sale,(Section 7044, Business and Professions Code). OWNER y ❑ I., as owner'of the'property,'am exclusively contracting 'MAIL with licensed contractors to construct the,project (Sec- ADDRESS tion•7044, Business and Professions Code). CITY TEL.-NO. CONSTRUCTION LENDING AGENCY I hereby affirm that there`is a construction LLlending agency for :' CONTRACTOR , the performance of the work'for which this permit IS Issued F7. (Sec.,3097,Civ.,C.). .. ,c _.. _ ADDRESS Lender's Name CITY Lender's Address STATE LIC. certify that I'have read this application and 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 for inspection ur,oses.• `'' SEE'REVERSE FOR EXPLANATORYLANGUAGE 2 1 Y % •SIGNATURE DATE - - -