HomeMy Public PortalAbout9061 LONGDEN AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0310210011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
L S PAID BUILDING .
TR: 12048 LT: 1 9061 LONGDEN AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801512
ASSESSORN NEAREST CROSS STREET: SULTANA
5382-021-027 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 2.00 COM 54.00
08 FURNACE/HEATER <100 2.00 UNI 54.00 ISSUED 0 .
30 AIR INLETS/OUTLETS 12.00 UNI 52.20 10/21/03 JK 04/18/04
41 VENTILATION FAN 1.00 FAN 15.75
OWNER: TEL. 0: TOTAL FEES 203.70 FINAL DATE FINAL CODE:
NAKAMURA TOSHIYUKI;TOMOMI (626) 285-7134- 4—/Z_c
9061 LONGDEN AV `
TEMP 917801512 DFSCRIPTIF WORK
MECHANICAL FOR ADDITION/REMODEL
APPLICANT:
TET INTERNATIONAL (626) 285-2562-
145 N EARLE ST SPECIAL CONDITIONS:
SAN GABRIEL 91775
GEL 's Cc
CONTRACTOR TEL. N285-2562 APPROVALS DATE INSPECTO SIGNATURE
RICHARD WU145 N EARLE ST LIC. NOFAU/WALL FURNACE
SAN GABRIEL, CA 91775 540918 B/
COMBUSTION AIR OPENINGS
ARCHITECT
II/ rDUCT WORK
LIC. NO-
THERMOSTAT`"�111�111 AC/C P E 0
IRE DAMPERS
D U �
COMMERCIAL HOOD
17
REPORT ID: DPR264 ROUTE TO: BS0508
WORKERS' COMPENSATION DECLARATION , A(�P C/„�5-i ��f�(I FOR
P2RNT
,i hereby,affirm that I have Q certificate of consent to self IT I�L� �b6�U U ll�l Ir Ili lS 111711 .
Insure, or a certificate of Workers' Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING
or a certified copy thereof (Sec 3800, Lab C )' 4C -
PohC{ No '• Company t 2 20-000-0046 DPW 9/86
❑, Certified,copy'is•hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY
El Certified copy,is filed with'the county building'inspec- FOR APPLICANT TO FILL IN BUILDING D
t tion department ADDRESS
4 (PRINT OR TYPE ONLY,)
,~Date Applicant LOCALITY e
NO TYPE OF APPLIANCE-OR EQUIPMENT _ FEE �-
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION INSURANCE CROSS ST .
ABSORPTION UNIT, BTU
(This seCtton need not be completed ifthe work involved?by DISTRICT NO PROCESS BY
-the permit Isifor one hundred dollars ($100)'or'16s.). O y
AIR HANDLING UNIT, v/J
I ertify that m•the performance of the work'for which this
cCFM
gper'mit'is•issued;d"shall not employ any person in any manner
BOILER, BTU -
'
so-as To become subject to,the Workers' Compensation Laws '• . •APPROVALS DAT INSPECTOR'S SIGNATURE
Date "Applicant COMPRESSOR, BTU ROUGH ,
r ' 'NOTICE TO APPLICANT If, 'after-makin • this•Certificate of 7
g VENTILATION SYSTEM FINAL
Exemption, you should become.subject to the Workers'' `
Compensation provisions of the Labor,Code, you'must forth- EVAPORATIVE COOLER r VALIDATION
with comply with-such provisions or this perpit shall,be deem-•
ed,revoked FURNACE FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU
I hereby affirm•that-I am licensed under'provisions of'Chapter 9 HEATER DE NIT—
-(commen ing'with,Section 7000)of Division 3 of the Business— ACt �
and Professions Code,•and'my license is in full force and effect'
• •: } ," - - - - - Com.
Lficense Number Gc,°Class D O _
V
j_-Contractor Date
'❑. I.am exempt 'under Sec- O
,." Plan check,f'ee " W
B'&P C for this reason a
PERMIT ISSUING FEE $ 5- �►
Date Z
Signature TOTAL•FEE
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT-
I,hereby affirm that,I am exempt from the Contractor's License ,
Law for 0 e following reason (Section 7031.5, Business and -NAME
offfessions Code) u
(�11 ADDRESS. ^ -'
/lQJ\ I, as owner of the properfy, or my employees with [�' �O A�.>�.'� e
' wages as their sole compensation,will do the work and -�" °g
CITY r TEL NO - C
" the structure is not intended or offered for sale(Section C e� �e C - - •. 3�7
7044,'Business and Professions Code) OWNER Teti
1, as owner of the property, am exclusively contracting /� ,' i Ail ITEMS
with licensed contractors"to construct,the prolect (Sec- MAIL
ADDRESS Q {.6 I Li 1 tL 30. 50
tion 7044, Business and Professions-,Code)
CONSTRUCTION LENDING AGENCY �p }I�.�C�{�i.� 0�ii 3
CITY-T- rn C TEL NO —s •i iL.�•r\ ZiJ°.ii
I hereby affirm that there is'a construction lending agency for i
the performance of the work for which this permit Is Issued CONTRACTOR • . °��)
(Sec 3097, Civ C ) D;
ADDRESS r.
Lender's Name �iyy���•yy '�Ri {e�� r
CITY y TEL NO _ ir• ,• •� VLiLiU—VLTV� "11! -�I J
Lender's Address -� o
I certifythat I have read this application and state that the, STATE LIC' 7, 70 1 ••, AM-9:0'f
PP LICENSE NO CLASS
above 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
upo he above-me ti ed property"for inspection purposes SEE REVERSE-FOR EXPLANATORY LANGUAGE
Sig afure of Applicant or Agent Date Os