HomeMy Public PortalAbout10634 1/2 LIVE OAK AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0907080009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 2B5-0488 EXT
ILEGAL ID I FEES PAID BUILDING ADDRESS,
ON FILE 1 10634 1/2 LIVE OAK AV E 1
IFEE DESCRIPTION QUANTITY UOM AMOUNT ARCD CA 910078567
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1
18586-009-011 101 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 597 GRID- D3 LOCALITY TEMPLE CITY, Cl
1 108 FURNACE/HEATER <100 1 00 UNI 27 00 I
ITENANT 11 TOTAL FEES 54 75 (ISSUED ON PROCESSED BY PLAN BY - EXPIRES ON 1
1 1 107/08/09 SR 07/08/10 I
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(OWNER TEL. NOIF F AL Y CODE
IMEI YANG -
110634 E. LIVE OAK AV pf1
(ARCD 910078343 1 SCRIPTS N OF WORK
- ICIO WALL FURNACE 1
(APPLICANT TEL NO 1 1 1
MARAVILLA FOUNDATION (323) 721-8883- 1
15729 UNION PACIFIC I ISPECIAL CONDITIONS. 1
(COMMERCE CA 90022 1 1 1
1 I
1 I
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
IMARAVILLA FOUNDATION (323) 721-8883- 1 _ 1 1
15729 UNION PACIFIC AVE LIC NO 1 IFAU/WALL FURNACE 1 1
(COMMERCE CA 90022 - 622969 1 I I I
I 'I ICOMBUSTION AIR OPENINGS
(ARCHITECT OR ENGINEER- TEL NO- IDUCT WORK 1
I — I I —1-1 f
I LIC NO- 1 IAC/COMPRESSOR I I 1
I I -•� -1-1 1
I �I _ ITHERMOSTAT. I -
I I I- T" 1 I
I 'I - (FIFE DAMPERS
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(SMOKE DETECTION DEVICES I I I
(COMMERCIAL HOOD
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* ADDITIONAL DATA ON FILE I I I
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IREPORT ID DPR264 ROUTE TO BS0508 1 I 1
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WORKER'S COMPENSATION DECLARATION' 20-0046 DPW'9/89 ®
I hereby,affirm that,I hays a'ceruf cafe'of conserit''to self Insure, 76A364C -' �PPUCATION,F•®,E'`71, PERN"'ll ,t
or,a certificate of_Worke�'s-Compensation Insurance; or�a^'`certrfiedl �` ' Y x
r
E:, G RE,iE,N
HEATING-VENTILAT.ING .AIR;CONDITIONING'
rcopy'th(reof(Sec",3800,Lab•C)' - - ; r f i
Policy,No' A' ' Company ,6. �' : -;COUNTY OF LOS ANGELES; DEPT OF PUBLICrWORKS', ' ,,, BUILDING AND'SAFETY DIV.
a, -El : Certified copy.is hereby furnished x _'�•;_ .! M
•-'�- Certified copy Is`fded}wrth the county 6udding,lnspection FOR'APPLICANT TO FILL IN ,' �+ ;BUILDING �Yf c r,'
-� trdepartment _ - ! --;t. • >3.� "' ..t' _ (PRINT OR TYPE ONLY) ,t' � ADDRESS "ice •,/ ,� 1,r f. ,,L„_'• -
x.� ,LOCALITY '"• Y, r >. '
r
Date Applicant = s
n '• - NO -TYPE OF APPLIANCE OR'EQUIPMENT" 'i ','FEE
_�'r,Y'CERTIFICATE OF EXEMPTION FROM WORKERS',' �c "w�, ' ' CROSE ST S ,+ ;� j',w �l
_ S �.,
COMPENSATION INSURANCE-'+' �' '` r e ' i
,r ABSORPTION UNIT,'BTU 1'w••, %r ;„ - s• y. +--
�t ASSESSOR'a
(Thisesectlo�`need notrbeacompleted if the work Involved by the. MAP"BOOKS 4,r PAGE PARCEL"
PARCEL'
Y' permit'is fowone hundred dollars($100)or less), ^'� „ AIR.HANDLING UNIT,CFM' ,
'y .,o ,t• - , : y- ' DISTRICT NO- - - PROCESSED BY
-P;I certify that,in the"petformance of the-work for which,this permits
is,Issued', I shall"not�employ.any person in anyymBin ner so as'to if BOILER,,
BTU• �• rr° t• t;~ r_ r'
become subject toythe Workers"
Compensatioh'Laws' r' n , cr ° r _ T -�• ={�'r �gTs c,_,,_ r
' '- - r�r• .i ti a+ ; ;f !'tet r' COMPRESSOR,BTU• -,'
'APPROVALS - DATE f, 'INSPE T R' -y
'-k f 3 Applicant l`• +r "'Id,!`�s: r �i'S ' 'i' ,," c o SSGNATURE
VENTILATION SYSTEM _
NOTICE TO APPLICANT If;,after making this Certficate'of.• 0" ROUGH "` ' „[
Exemption,'you should become,sulitect'to the Workers' Compensation^
t - ,,;, EVAPORATIVECOOLER�,� f t• - k -
provisions of the Labor,Code;you•m, t`,_forthwith comply witFi,such,i. '.•" FINAL" y,<.; •rl
provisiohs or,Ihis,permit-shall be,deemed revoked :4. FURNACE FAU-' ''GRAVITY ^-
` LICENSED,CONTRACTORS=DECLARATION - �t_/• ; FLOOR n BTU jt=r ' r4° VALIDATION i a
;I hereby affirm-tfatl am'hcensed,under provisions'of:C_hapter-9 SUSPENDED ` UNIT '"' a�`•w_ t,? Vit''.
(commencing with Section 7000),of Division"3�of.the Business;and HEATER :N/ALL""'• y
'r Professions"Code,and my license Is.In'full force and effect
<1� .q •, ,-5,Y '.,'- 'r"-,i,.i _ 'C• l ,r ;Id'•'.s--f y� _5:�`` - ., s "
License Number `P/ ' 4 ' f e f-lc-Class
N5l,:'' {`r�::-"'' :•'. ..+tii r'.if , :i R - Y4f �® - a `�,rye Y Y 0'"4 - -`• ''ti }
Contractor; �,A .a'�,+•"� ,r;r 1', 1 Date 0
f
} I - Plari'check fee q
am exempt under Sec f,j�' ',Z �' W
`o,w , B'&P C for this reason i+ 1' PERMIT-IS"SUING',FEE,$I
Date' TOTAL FEE '..• �jti ; r- 4 �` i' , }r�
" SSignature
PLAN CHECK APPLICANT,t`r^+ . - -- -- - •g^ �;, -- } 1.•,' _,�; -•t- x ,«q,1 t .c •,�
OWNER-BUILDER DECLARATION, �' F '.v• O
" _Pl.hereb affirm that I am ezem t`from the t
y „ _ p e•'Contractor's License Law NAME
`fo�rtherfollowing'reason (Section 7031°5, Business and,Professions
COdB) LU
'ADDRESS•< 1
I,'aslowner,of�the property; of my'employees,with,wages a s^ »,,t•.'•g' M� y , ( r•
as ttieir;,'sole�compensa,tion, vJill:do the work and'the - CITY TEL NO
stir, .�'•,r _ - .` .r
stiucture;is;not-intendedror offered for sale (Section 7044, fs {'o.tir '
:• $usiness�and-Professions Code) �, "OWNER-r>,+i ! �•' s y+ ^G, .x v, h~ " 't `f."f; " , "�
Df t '< - ` �� +�
`a
1, as owner of th`etproperty,,"am exclusively contracting MAIL
�_.•'t•with licensed„ contractors'to•construct'the project ADDRESS'[ r �°. "r+;, l; 1., ,'i,. a .r,' y ,
x °tion"-7044:, usinessia`nd Professions Code)' �-
f_ r'`y It r .�r,#� �•
CONSTRUCTION LENDING'AGENCY`� -CITY• t !' ,? J fs� TELr4N0,»jr� Y '�, pp,�� �
r� 'I hereby affirm.that'theie:ls`a;construction lending agency for
N the performance of`the^.,work,for which-this permit is^'Issued. CONTRACTOR
(Sec-3097;Cii-C
ADDRESS d ,:r •s' ' `,t„” `
_ f
Lender'sName ;As�„!`1' 1d �'t
CITY ,r •� ° ' r5 '' TEL NO
Lenders Address ,
STATE LIC
! •Ic ertify,that I•havt;read this application and State that the above LIC_ENSE N_O 7;/ ;+`- rl �N CLASS�,1,
formation Is correct'.I agree to comply with all County ordinances; * „
J' r r •,
ty and'State laws;relating'to bwlding.construction,and hereby authorize• : , _ , s '• .
+r^'`�epresentatives;of this County to-enter;upon the above-mentioned,
property for.inspectwn'purposes SEE REVERSE FOR EXPLANATORY"LANGUAGE `
V{ ' _ - i� a it�' >• "' - , r , - t
yi''isTSIGNATURE,OF APPLICANT OR AGENT - i •.DATE',•, =°" -_ i _ t•'a' - -1. ", '• a ; "- -t -