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Home My Public Portal About9750 LEMON AVE_Mechanical__ 76 0364'- Ce 818- 5-73 APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES BUILDINGq DEPARTMENT OF COUNTY ENGINEER ADDRESS / —_ 0 e- ,V e- BUILDING AND SAFETY DIVISION LOCALITY Gi k NEAREST CROSS ST. FOR APPLICANT TO FILL IN OWNER (PRINT OR TYPE ONLY) e y MAIL NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS CITY TC� ' '� TEL.'N0. ABSORPTION UNIT, BTU CONTRACTOR w AIR HANDLING UNIT, CFM ADDRESS BOILER, BTU CITY TEL. NO. COMPRESSOR, BTU STATE LIC LICENSE NO. CLASS VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY EVAPORATIVE COOLER �J f FURNACE' FAUGRAVITY FLOOR BTU INSPECTION RECORD HEATER SUSPENDED UNIT_ WALL d 0 U O H U W C C/) Z Plan check fee 25% of above. See reverse. PERMIT ISSUING FEF. 8 3 00 TOTAL FEE a0 PLAN CHECK APPLICANT NAME ADDRESS. CITY TEL NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CO RRtCT AND AGREE TO COMPLY WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE LATING, AIR CONDITIONING ROUGH I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION 117 OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL �� CODE OF THE STATE OF CALIFORNIA SIGNATURE `' PERMIT VALIDATION CK. O CASH OF PERMI PLAN CHEC LIDATI N CK, M 0 CASH 174 3141 a 8.00-® ,, SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ` WORKERS' COMPENSATION DECLARATION APPLICATION FOR PERMIT I hereby affirm that I have a certificate of consent to self Insure, ora certificate of Workers' Compensation Insurance, 76A364C HEATING - VENTILATING - AIR CONDITIONING or a'"certified copy thereof (Sec 3800, Lab C ) CE-818(REV'10/81) - Policy No Company Certified copy Is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ Certified copy Is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING ,( tion d .(epartment ADDRESS ^O ��'-r�N ,VIF (PRINT OR TYPE ONLY) Date Applicant LOCALITY NO TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST (This section need not be completed if the work Involved by ABSORPTION UNIT, BTU DISTRICT NO PROCESSED BY the permit is for'one hundred dollars ($100)or less.) `1!/ I certify that in the performance of the work for which this AIR HANDLING UNIT, CFM r UOV permit is issued, I shall not employ any person In any manner so as to become subject to the Workers'Compensgijbn Laws BOILER, BTU APPROVALS DATE INS PTO SIGNATURE IK Date —1 pplicant _eC — COMPRESSOR, BTU ROUGH NOTICE TO APPLICANT If, after making this Certificate o 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 affi?m that I am licensed under provisions of Chapter 9SUSPENDED UNIT (commencing with Section 7000) of Division 3 of the Business HEATER WALL and Professions Code,and my license is In full force and effect License Number Lic Class V Contractor Date V ❑ I am exempt under Sec W Plan check fee n. B 8P C for this reason PERMIT ISSUING I Z Date Si ature ' -TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I her y affirm that I am exempt from the Contractor's License , Law for the following reason (Section 7031 5, Business and NAME �tiLT r essions Code) _ ADDRESS - j, as owner of the property, or my employees with �rq�/ ,f}�/Z wages as their sole compensation,will do the work and —1_ the structure is not Intended or offered for sale (Section CITY �_�, �L� fie. TEL NO - r 7044, Business and Professions Code) �r� i ' Aq ❑ j, as owner of OWNER the property, am exclusively contracting AUT.11'r with licensed contractors to construct the project (Sec- MAIL _ ��, �� 1 tion 7044, Business and Professions Code) ADDRESS 3307 20,._ CONSTRUCTION LENDING AGENCY CITY '- G� ��/ TEL'NO ,� q TT J I hereby affirm that there is a construction lending agency for v 1 1! the performance of the work for which this permit is Issued CONTRACTOR , {{ Lender's Name (.'f.f ,. (Sec 3097, Civ C ) TOTAL r ADDRESS CCY, ,. 410!.50 CHANGE .00CITY Lender's Address - " STATE LIC I certify that I have read this application and state that the LICENSE NO CLASS r above Information Is correct I agree to comply with all County ; 00o—LIoa1 1/ 4/'-i7Cn ordinances and State jaws relating to building construction, 00-96 1 A �1oct� and hereby authorize representatives of this County to enter up n•the abov endo ed operty for inspection purposes SEE REVERSE FOR EXPLANATORY.LANGUAGE G' Signature of Applicant or Agent Date ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - ME 0508 0603130008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 ERT LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 9750 LEMON AV E FEE DESCRIPTION QUANTITY UOM: AMOUNT. TEMP CA 917800000 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET 5383-016-006 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE: GRID 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 ON: 30 AIR INLETS/OUTLETS 10 00 UNI 43.50 03/13/06 JK 09/09/06 54 NO PERMT $224 70 MIN 257.00 257.00 OWNER TEL NO. TOTAL FEES 382 25 FINAL DA X p��y ED BY: CODE. CHANG CHARLES S,ANN Y (626) 241-2899- IB��j Ai�®,i/p9750 LEMON AVTEMP 917800000 DESCRIPT O WOR INSTALL AIR CONDITIONING AND HEATING SYSTEM APPLICANT: TEL. NO GEAR HEATING 6 COOLING (323) 724-9800- 1415 ESPANOL AVE SPECIAL CONDITIONS MONTEBELLO, CA 90040 CONTRACTOR. TEL. NO APPROVALS DATE INSPECTOR SIGNATURE GEAR HEATING 6 COOLING (323) 724-9800- 1415 ESPANOL AVENUE LIC NO FAU/WALL FURNACE MONTEBELLO, CA 90640 522700 C20 COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER TEL. NO DUCT WORK LIC NO - AC/COMPRESSOR THERMOSTAT FIRE DAMPERS SMOKE DETECTION DEVICES COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO. BS0508