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Home My Public Portal About9403 LAS TUNAS DR_Mechanical__ I WORKER'S COMPENSATION DECLARATION 20-0046 DPW 9/89cit _ .AAS r Fit I'hereby affirm that I have a certificate of consent to self insure, MW ' 76A364C APPLICATION FOR PERMIT Y ' or a certificate of worker's Compensation Insurance, or a certified HEATING-VENTILATING -AIR CONDITIONING., copy thereof(Sec.3800 Lab. C.) P Policy No. ( Company' s f COUNTY OF LOS ANGELES DEPT OF.,PUBLIC WORKS BUILDING AND SAFETY DIV: Lam" Certified copy is hereby furnished. ` ri .if t BUILDING r Certified copy is,filed"with the county building,i 5pection FOR APPLICANT TO FILL IN ADDRESS_ `• �� a PRINT OR TYPE ONLY department. ( ) I i LOCALITY 3' r Date => Applicant �` %�, NO. TYPE OF APPLIANCE OR EQUIPMENT - FEEt-• ��r� y 1I`' NEAREST CERTIFICATE 011EXEMPT�O FAO WORKERS CROSS ST. COMPENSATION INkRANCE ABSORPTION UNIT,BTU his section need not be completed if the work involved b the ASSESSOR • (T. P Y MAP BOOK PAGE PARCEL - permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM DISTRICT NO. PROCESSED BY I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any:manner so as to BOILER,BTU become subject to the Workers'Compensation Laws. f COMPRESSOR,BTU ' -APPROVALS DATE INSPECTOR'S SIGNATURE ' Date Applicant _ VENTILATION SYSTEM NOTICE TO APPLICANT: If, after making this Certificate of. ROUGH Exemption,you should become subject to the Workers' Compensation EVAPORATIVE COOLER provisions of the Labor Code, you must forthwith comply with such FINAL provisions or this permit shall be deemed revoked. FURNACE: FAU , GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTUVALIDATION I hereby affirm that I.am licensed under provisions of Chapter 9 HEATERSUSPENDED UNIT : (commencing with Section 7000) of Division 3 of the Business and WALL Professions Code;andmy license is in full force and effect. £ . License Number + /' Lic.Class O Contractor Date ✓ , : Plan check fee �• r U I arr ex n�pt under Sec. r W B.&P.C.for this reason PERMIT ISSUING FEE$ LL Date: TOTAL FEE Signature Q OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT tt O I hereby affirm that I am exempt from the Contractor's License Law NAMEtlL. ' ' rr~ CL for the following reason (Section 7031.5, Business'and Professions , �" '' 2 ❑ Code): H) ADDRESS '. - - 1, as owner of the property, or my employees with wages t"( $ as their sole compensation, will do the work and the CITY TEL.NO. structure is not intended or offered for sale (Section 7044, Business and Professions Code). OWNER r r r^ st,l.tw''6"�' Q" 1, as owner of the property, am exclusively contracting =MAIL f,/ L € Lf with licensed contractors to construct the project (Sec-. ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY �� I `1�, A TEL.NO. Ihereby affirm that there is a construction lending agency for CONTRACTOR f�the-performance erformance of the work for which this perm t Is issued (Sec. Civ. C.). ADDRESS : �!,*1 Lenders Name' J'� �t CITY{� ,/4r i TEL.NO(r, - Lender's Address STATE LIC. / certify.that I have read this application and state that the-above LICENSE N0. CLASS information is correct. I agree to comply with all.County ordinances and State laws relating to building construction,and hereby authorize representatives of4Is County to enter upon the above-mentioned property for ins�'t:ltion,,purpo 6s. SEE REVERSE FOR EXPLANATORY LANGUAGE f SIC ATI tE OF7PPLICANT 6 r ENT —T—�{DATE - , I ';,ARP,l,ON CEA3 8 (2-80) A p'P-'00QT�00 N FOR PC RMT I hereby affirm that have certificate of consent to self insure,or a certificate of\�Iorkcrs Compensation insurance,or a certified copy thereo fj(Sec. 3£0^. Lab.C.) Policy No.ZI220 L 6✓"_omps:iy_ Nfk� 0_w Ps I Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUOLDVf1 G AND SAlFE7Y Certified copy is `Il.:d with the cour._y iiuilriing inspection - -- F®R APPUCANT 70 [SELL M BUILDING department. ,p ADDRESS e-r Date !- [ f pplicar.i._(p-.-1 ��'t/ (PRINT OR TYPE ONLY) ti LOCALITY CERT1?ICATc O. L i Oi' 'lt0? \'v OR Ki:RS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CO,1iP;_ \Si'Z �C NEAREST I � (This section -need .-,a_ .;he wc;lc :rtvolved ABSORPTION UNIT, BTU CROSS ST. CL by the permit i5 '-,c q_1_ _ _ _'aJ0'( 03) 0!: less.) DISTRICT NO. PROCESSE ,Y 0 �. I certify thri is the ;.rt,;;T.ence Lf LJic '.'rrr': for which this AIR HANDLING UNIT,CFM Cr permit is issued. 1 sh::il not eniplu) an)' person in any manner so as to become subject :.o the \V,irkars' Uompenshtion Laws. BOILER, BTU 0 APPROVALS AT IN ECTOR'S SIC NATURE V Date Appl:L;nt _ �Z. COMPRESSOR,BTU— - !'aC)LO— ROUGH _ d Cn NOTICE TO APPLIC,\N C: Is, sfter mrkir,, this Certificate of VENTILATION SYSTEM FINALF�AZ Exemption, you should beeo-11L sc'lject to The Workers' Compensation 7-r^si irs of th,: .-_:i,o- _ode, yna must forth- with oomph' �.'th such :u^= m t 1's permit shall be _ deemed revohec• FURNACE: FAU ! GRAVITY / LICENSED CU :'+t A:"'T3'iSt)rCi.,1RA'ii01�r � �FLOOR' BTU—/_OAS-QQf7— �0 /00 9ay^ I hereby affiri iha- I I-,- i c„ sad .0 ovisio-s of Chaoter HEATER: SUSPENDED UNIT 9 (commencing;9,it l S__.ien ^,G^,) n` „•;isic.n 3 rf the Susi- WALL ness and Pro'iessions Cu+e, -ci : licinse is in full force end -'38 a2 0 effect. "Z License Numbr._I 3735 Contractor Cvw.Nast__ D ® I am e-wTrpt from" "lie '' cr ink -ecluirements as I am a licensed srchi'cc: o - Pere p:ofess:onal engineer Plan check fee 25%of above. acting in my „rrfessioo.l Lapac:t, (Section 7051, Bus- iness ane Profess'ons Cocic). PER(li 7 ESSWNG FEE $ Lie.or Reg. No.—___ _ De:e ®7AL FEE I101i1:O\!'li' t-3U11.D :t Dr:C'LAll ,TTON PLAN CHECK APPLICANT I'. I hereby a',-irm that 1 - o .er,,pt 'f un the Contractor's NAME License Law for the iI>Iknn g nu s .i 1 .__;on "7031.5, Busi- ness and Professions C'nd.): ADDRESS z 3 9 S&A 1, as owner of the property, will do the ,vorlc and the TEL. NO. structure is no't i lien :ee, of.cfrs'.L1 for sale (Section !'CITY Q-oK..IV riQ-v (yC 7044. Business and :ofess:uns Cade). r o- l 0 0 0 0 0 OWNER I, as owner of i;ie property, an e;:clusively contracting P0{1—AJC20 2`-- 50,50 with licensed ont:acturs io construct the project MAIL Q 3 (Section 7044, 3us-rens, L: ':ofessioas Cede). I ADDRESS CONSTRUCTION LENDING AGENCY [CITY TEL.NO. ? �!7 /y/q ��/1� e - I hereby affirm that tSrre is + co,lstru �� ction lending agency o o 0 5 Q,5 Q 5 for the performanc of the wo "' 1nr wCONTRACTOR which this permit is �p/�/✓O/� C �C /Lr �IUC " ! issued (Sec. 3097,Civ.C.). / 0 9, p 5'—8 4 Lender's Name ADDS RESS_e{G 9f� Lender's Address I1 CITY !LJ TEL. NO.(lClr_ 5/ IP/e I certify that 1 have read this epplic_tiun and state that the STATE ya,373 CLASS Seamy a above information is correci.1 cam gree to ply with all County LICENSE NO. ordinances and State 'aiws regulating Heating. Ventilating and -- Air Conditioning, anc: I--ereby autheriac representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE County to tinier L?n.1 the L:'.iuve-Irentiuned property for insnP;tion purnnses � - lyy Signature of°ermittea Da?L COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0602210004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 350 BL: .001 9403 LAS TUNAS AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801927 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-007-014 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C 02 COMPRSR < 100 KBTU 3.00 COM 81.00 TENANT: 08 FURNACE/HEATER <100 3.00 UNI 81.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 30 AIR INLETS/OUTLETS 19.00 UNI 82.65 02/21/06 JK 08/20/06 41 VENTILATION FAN 3.00 FAN 47.25 OWNER: TEL. NO: 47 ALTER EXIST DUCT SYS 4.00 SYS 108.00 FINAL DATE FINAL BY: CODE: MARKESE, VINCE (626) 446-3846- TOTAL FEES 427.65 ,;�Zx•--� 375 W. LONGDEN ARCADIA, CA 91006 DESCRIPTION OF WORK REPLACE 3 A-C UNITS FOR TENANT IMPROVEMENT APPLICANT: TEL. NO: BOWMAN AIR CONDITIONING (626) 446-7444- 157 E. SANTA CLARA SPECIAL CONDITIONS: ARCADIA CA 91006 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE BOWMAN OF ARCADIA (626) 446-7444- 157 E. SANTA CLARA LIC. NO - FAU/WALL FURNACE ARCADIA, CA 91006 295706 C20 COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK BOTICH ARCH. 4516 RIM CREST DR. LIC. NO: AC/COMPRESSOR NORCO NONE THERMOSTAT ` FIRE DAMPERS SMOKE DETECTION DEVICES COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO: BS0508