HomeMy Public PortalAbout6029 LOMA AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0908100010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I FEES PAID BUILDING ADDRESS:
ITR: 5904 LT: 349 1 I 6029 LOMA AV'
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I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801926
ASSESSOR INFORMATION NUMBER: - I I' NEAREST CROSS STREET:
15384-014-021 _ 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl -
1 102 COMPRSR < 100 KBTU 1.00 COM 27.00 1
(TENANT: 1.08 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: 1
130 AIR INLETS/OUTLETS 8.00 UNI 34.80 108/10/09 SR
1 I TOTAL FEES 116.55 1 1
(OWNER: TEL. NO: I IFINAL DAT BY: CODE: -
1ZUO P. WANG (626) 292-1151- 1 1.
16029 LOMA AV
ITEMP 917801926 1 IDESCRIPTION OF WORK 1
11NSTALL AIR CONDITIONING AND HEATING SYSTEM 1
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(APPLICANT: TEL. NO: 1
ITHIRD GENERATION & CONSTRUCTION (818) .533-6722-
112101 OLIVOS RD. ISPECIAL CONDITIONS:
I SYLMAR, CA 91342
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ITHIRD GENERATION CONSTRUCTION, INC. (818) 533-6722- 1 .
113469 LOS OLIVOS ROAD LIC. NO 1 1FAU/WALL FURNACE 1 I 1
1SYLMAR, CA 91342 893694 1 1
- I ICOMBUSTION AIR OPENINGS 1
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1ARCHITECT OR ENGINEER: TEL. NO: IDUCT WORK I I I
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I LIC. NO: I IAC/COMPRESSOR
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1 I. 1THERMOSTAT 1 1
IFIRE DAMPERS
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ISMOKE DETECTION DEVICES
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IREPORT ID: DPR264 ROUTE TO: BS0508
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364C
WORKERS'COMPENSATION DECLARATION CEA 818-(2-80) APPLICATION FOR P E R tlVp T
I hereby affirm that I have a- certificate 'of consent to self
insure, or a certificate of Workers'Compensation Insurance,o'r -p(EqTINw-VENT IL ATINCty-i�lffd CONDITIONING
a certified roov thp—of(Sec.3800 �.ah:(�l
-oc�- Gcl }u Ste--
Policy No. �,� Compan����g O
Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETYS
f
Certified copy is filed with the county building inspection. BUILDING 'A�
derartment. FOR APPLICANT TO FILL IN _^ +�(� � ZOu/l
Date_,-F�; Applicant,&J�S_ �� /�`-��Q/fib NO.
(PRINT OR TYPE ONLY) ADDRESS ' O' L �/�
LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS TYPE OF APPLIANCE OR EQUIPMENT FEE �
COM PEN SATION'INSURANC E NEAREST U)000�<D ^���
(This section need not be completed if the work involved ABSORPTION UNIT, BTU' CROSS ST. a
by the permit,is for one.hundred dollars -($100) or less.) DISTRICT NO. PROCESSED BY O
I certifythat in the performance of the work'for which 4his AIR HANDLING UNIT,CFM0(y",permit is issued, I_shall not employ any person in any manner ( _ 0
so as to•become subject to the Workers' Compensation Laws. BOILER, BTU
.. APPROVALS DATE INSPECTOR'S SIGNATURE V
Date Applicant COMP.RESSOR,BTU ROUGH �Qs�Z� N
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL 1
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLERVALIDATION
with comply with such. provisions or. this 'permit shall•be
deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION 4* FLOOR:— BTU
I hereby affirm that I am licensed under provisions of Chapter ) HEATER: Sl IQP NDED UNIT
9 (commencing with Section 70QO) of Division 3 of the Busi- / WALL_
ness and Professions Code, and my license is in full-force and
effect. ,cam
License Number 1r�/_00* Lic.Class 11y
Contractor_A-Ni'Q/661 Date
RI am exempt from the licensing,requirements as I am a
licensed architect' or a registered professional engineer Plan Check fee 25%of above.
acting in my.professional, capacity (Section 7051, Bus-
iness and ProfessionPERMIT ISSUING FEE:
Professions Code). �.
Lie.or Reg.No. Date TOTAL FEE
HOMEOWNER-BUILDER DECLARATION. PLAN CHECK APPLICANT
1 7
51 A
I hereby that. I am exempt from- the Contractor's NAME 1r c
License Law, for the following reason (Section 7031.5, Busi- + � —/ #I,o'o 0 0 a
ness-and Professions Code): ADDRESS W� �--
1, as owner of the property, will do the work and the 0.7Q ,2 odo'
Oo`�yv $QQ 23.5 0
structure is* not _iCITY � TEL. Nntended or offered' for sale (Section Q + e� 2 3 5
7044, Business and Professions Code). 0 v
I, as owner of the OWNER KI
,/�k�� �
property, am exclusively contracting J` K_ p 8 2
with licensed contractors to construct the project MAIL �// /h/�/�/'�^-
(Section 7044, Business and Professions Code). ADDRESS b0al JVv Z-01 01�f
CITY. f TEL.NO.
CONSTRUCTION LENDING AGENCY "GJ° j a3
I hereby affirm that there is a construction lending agency /� n'
for the performance of the work for which this,permit is CONTRACTOR )L/�7`_jJ�1/T,� L—A a,W,
issued (Sec: 3097;Civ.-C.). �J/'�+J W'{ D—Ie(�.r!J l�
Lender's Name ADDRESS f'/.�
Lender's Address CITY TEL, NO.
I certify that I have read this application and state that the STATE LIC.
above information is correct.I agree to comply with all County- LICENSE NO. ( � CLASS C_
ordinances and State Jaws regulating Heating, Ventilating and
Air Conditioning, and hereby-authorize representatives of this <gEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter upon thtioned property for
'inspection - rrpo T
_ CCS
Signature, f Permittee Date __