HomeMy Public PortalAbout9810 LAS TUNAS DR_Mechanical__ ION
WORKER'Shave a certificate
of consent to 20ooaeDPW sfes APPLICATION FOR PERMIT LIME GREEINN.
7aA364C
I hereby afiL:m that I have a certificate of consent to self insure,
or,p EarUficate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING
copy thereof(Sec.3800 Lab.C.)
— ��.CC�1panyPolicy N.�� J
Poli� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
LTJ Certified copy is hereby furnished..`
❑ BUILDING l o V1
Certified copy Is filed with the county building inspection FOR APPLICANT OR TM E TO IN ADDRESS T/ 1 ✓!` 'V . V
department. ' �J,t ( )
Date '� Applicant eQ" LOCALITY • ��
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPT FROM WO ERS' NEAREST
CROSS ST..•
COMPENSATI INSURANCE ABSORPTION UNIT,BTU
(This section need not be completed if the work Involved by the MAP BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit ��pp
is Issued, I shall not employ any person in any manner so as to BOILER,BTU ` �� r
become subject to the Workers'Compensation Laws. A �
COMPRESSOR,BTU f / Y
APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of 1 ROUGHEF
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code,you must forthwith comply with such FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION
I hereby affirm that Iam licensed under provisions of Chapter 9 SUSPENDED UNIT
(commencing with Section 7000) of Division 3 of the Business and HEATER: WALL
Professions Code,and my license Is in full force and effect.
License Number V Z� LID.Class
Contract�'{5 Vz A_L /_0�—Date �F e7"KI 0 -) '- a
❑ I am exempt under Sec. 49 Plan check feei = 0
B.&P.C.for this reason PERMIT-ISSUING FEE$ y ' - _ 0
Date: TOTAL FEE I!I j,4`L __� o ,� 0
Signature PLAN.CHECK APPLICANT :h;: - '•I Cn
OWNER-BUILDER DECLARATION :•I trtT_� o iIJ
I hereby affirm that I am exempt from the Contractor's License Law NAME an- C-e-7 PI-C-7 ,
for the following reason (Section 7031.5, Business and Professions ��,, �j y��, �. t
Code): ADDRESS 1'1�V- Iov %� '•�I.il i�—I'+ L'•{i _lir �.
I, as owner of the property, or my'employees with wages _
as their sole compensation, will do the work and the CITY. �rL_I,AVNW TEL.NO. �-y-2''h�! _)16_{
structure is not intended or offered for sale(Section 7044,
Business and Professions Code). OWNER -til ��'� Nj�Al-- WP. �p�!
❑ I, as owner of the property, am exclusively contracting MAIL / t l
PW
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044,Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITY rD 'A TEL.NO.
I hereby affirm that there is a construction lending agency for �yr ►
the performance of the work for which this permit Is IssuedCONTRACTOR l'•r�
(Sec.3097,Civ.C.). y
ADDRESS P I �v
Lender's Name �
CITY �V7. �.A TEL.NO.
Lender's Address STATE LIC.
I 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 purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SI TURE OF APPLICANT AGENT DATE
�• 1
�1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 NECHAN1CAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS HE 0508 0408200001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780p
PHONE: (626; 235-00488 EXT:
LEGAL D• FEES AI ^ ;'�—
TR: 6561 LT: 441 BL: .001 9810 LAS TUNAS DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: i TEMP,CA 91780?208 "
ASSESSOR INFORMATION B `"''.NEAREST':GROSS''"STREET: GOLDEN'-WEST`'-"'
8587-027-027 01 PERMIT ISSUANCE FEE" 27.75' THOMAS PAGEf 597 GRID: 'A3" ' 'LOCALITY:,TEMPLE CITY, C
30 AIR INLETS/OUTLETS 13.00 UNI 56.55
TENANT: TOTAL FEES 84.30 I S E 0 ROC SS BY: PL B -EXPIRES ON:
HEALTHCARE PARTNERS , 08/20/04 JK 02/16/05
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
SHI JR-MING;YU-HUEI (626) 446-9788- A�2
2006,TERRA LN
ARCD:910078141 DESCRIPTION .K
TENANT' IMPROVEMENT - RELOCATE. SUP PLY AIR GRILLS & RETURNS
APPLICANT: TEL. 0:
VELASCO (323) 847-7405-
21414-S. ALAMEDA ST SPECIAL CONDITIONS:
CARSON CA 90810
CONTRACTOR: •• TEL. 0: :1..r:.,•. �{+. .. _ APPROVALS . DATE INSPECTOR SIGNATURE
D C DANCO AIR CONDITIONING CO (323) 847-7405-
21414 S. ALAMEDA ST LIC. NO FACTIWA[L FURNp€�— —`
CARSON, CA 90810 698149C20
COMBUSTIOff AIR OPENINGS
ARCHITECT OR ENGINEER: —�� ��b: �DUCT OR
ENVISION ARCHITECTURE (310) 839-7:15-
3647 KALSMAN DR., #1 . LIC. NO: AC/COMPRESSOR.
LOS ANGELES, CA 90015 NONE
THERMOSTAT
FIRE DAMPERS _
IS-00K DETEC ION uE1IC
_ ICOMMERCIAL HOOD i
REPORT IDe 60264 ROUTE TO: BS0508