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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT'OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0805210008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID BUILDING ADDRESS:
ITR: 6561 LT: 632 BL: .001 1 9566 LAS TUNAS DR
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802106
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: PRIMROSE
18587-015-015 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
147 ALTER EXIST DUCT SYS 1.00 SYS 27.00 I I
TENANT: I TOTAL FEES 54.75 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I
(FRUIT BERRY YOGURT 105/21/08 SR 11/17/08 1
(OWNER: TEL. NO: I FINALDATEFINF�, BY: CODE:
1POLA WANG (626) 292-1356- 1 /7/
19544 LAS TUNAS DR. I 1 1
(TEMPLE CITY CA 91780 1 1D S RIPTION OF WORK I
I I (TENANT IMPROVEMENT ALTERATION OF EXIST DUCT SYSTEM I
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(APPLICANT: TEL. NO: I I I
IARCHIART CORP. (626) 581-7738- 1 1 I
117637 ROWLAND ST. I (SPECIAL CONDITIONS: I
11NDUSTRY CA 91748 1 1 1
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(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
IARCHIART CORP. (626) 581-7738- 1 1 1
117637 ROWLAND ST., #E LIC. NO I IFAU/WALL FURNACE I I I
(CITY OF INDUSTRY, CA 91748 900395 B I1 I
I I (COMBUSTION AIR OPENINGS 1 I I
(ARCHITECT OR ENGINEER: TEL. NO: I (DUCT WORK I I
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I LIC. NO: I IAC/COMPRESSOR 1
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I I (THERMOSTAT ,I I I
I I 1 11 1
I I (FIRE DAMPERS I I 1
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I I (SMOKE DETECTION DEVICES I 1 1
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I I (COMMERCIAL HOOD
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I (REPORT ID: DPR264 ROUTE TO: BS0508 I 1 I
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O icERS'COMPENSATION DECLARATION CSA$$(2 80) n p p p �� p� �I FOR p�n / ��
I hereby affirm that I have a' certificate of consent to self G�1 L� G J R R
insure, or a certificate of Workers'Compensation Insurance,or D,1IEATING_VIENTIL.ATING•AIR CONDITIONING
a certified copy thereof(Sec.3800,Lab.C.) LI
Policy No. 108589L7-8a9ny STATE FUND
U Certified copy is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY
13 Certified copy is filed with the ,.)urty b,,l'-.ng inspection FORAPPLICANT TO FILL IN BUILDING
department. ADDRESS 9566 Las Tunas Dr .
Date_3-=21=H9,pplican. (PRINT OR TYPE ONLY)
CERTIFICATE OF EXF v)p::JN FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Temple City
COMPENS'.MON INSURANCE NEAREST
(This section need not ,e completed if the work involved ABSORPTION UNIT, BTU CROSS ST. Temple C 1 ty Blvd.
by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. PROCESS:D w O ,
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM �) U
permit is issued, I shall not employ any person in any manner 5
so as to become subject to the Workers' Compensation Laws. BOILER, BTU VO
1 !� l APPROVALS DATE INSPECTOR'S SIGNATURE V
COMPRESSOR,BTU 48 s QU V v ROUGH w
Date Applicant
_ 00 a
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM y
Exemption, you should become subject to the Workers' FINAL Z
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALI TION
with comply with such provisions or this permit shall be
deemed revoked. FURNACE: FAUGRAVITY \
LICENSED CONTRACTORS DECLARATION FLOOR: BTt7 U V
I hereby affirm that I am license. ,nder provisions of ChapterHEATER: SUSPENDED UNIT �\
9 (commencing with Section '7 0 )of Division 3 of the Busi- WALL f)` f �
ness and P—'--ior Code, a. Ay license is in full force and �(f
effect n -
Lice n e Numb; 509 Lic.Class C-20 &Roof top—Package) ! //
Contracto,_ _ late 3/20/89 7
0 !1 r, exe'.pt from the licensing requirements as I am a
cer,.._. architect or a registered professional engineer Plan check fee 25%of above.
scling in my professional capacity (Section 7051, Bus33
-
iness and Professions Code). PERMIT ISSUING FEE $ ,(' 'V'l _I_7L�.IEI
Lic.or Reg.No. Date TOTAL FEE O SV !TEMI"'
D �p
HOMEOWNER-BUILDER DECLARATION PLAN CHECK APPLICANT —/� [_Ijj-1 off+
I hereby affirm that I am exempt from- the Contractor's 3_110.5111,
p NAME t-3ECK
License Law for the following reason (Section 7031.5, Busi- '
ness and Professions Code): ADDRESS CHANGE 0
I, as owner of the property, will do,the work and the
structure is not intended or offered for sale (Section CITY TEL. NO.
7044, Business and Professions Code). 1`s—� gO�
OWNER `yr 17
I, as owner of the property, am exclusive) contractingMr • Charles - r. i t ,-,—
with licensed contractors to construct the projecMAIL .40-`f 1 AM 19!_
(Section 7044, Business and Professions Code). ADDRESS 1120 So . Second Ave .
CONSTRUCTION'LENDING AGENCY CITY Alhambra CA TEL-NO. 445-6030
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is CONTRACTOR LANE ' S AIR CONDITIONING
issued (Sec. 3097,Civ.C.).
Lender's Name ADDRESS P .O . BOX 1993
Lender's Address CITYTEL.NO.
Monrovia 303-4168
I certify that I have reap his application and state that the STATE 509210 CLASS C-20
above information is co .e [.I agree to comply with all County Li CENSE NO.
ordin.^ _ and State �a�-s regulating Heating, Ventilating and
r Con ioninga .d '.ereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
Co5. ��
the above-mentioned roperty for
in
_ 3 a/
i e of Permittee Date
I
I P "e
c r 1 1-i p
FriCl—ifi-21! CI�T- h 0 i G&; TY OF LOS ANGE 1—FS Bt's!-C)!l`,!G AND SAFETY
I'! T
'Y
P Lf .4.',T 0 F 1 L 1
-T�-'2 T 4DDF�FESS
Da,e 'Pli'a-11 F T C��F� -1 Y P E CIN L ')
i T Y
C L P T I F i C T L Or f-X 3
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71 R C'S'S ST. I v ♦ LLJ
(This section n(!Ed not ill c c!-3:7 J t i f !j
by the permit i- for one -D
LL
permit is issued. I shall noi e a ', V-lS
cr
-�-ii -e i,
so as To become suh:,�ct to o r L <
i a-PPROVALS DAT. INSIEC. R'S S I GN'A
cc
f)a,,,-- Applicant -- 7� P,1 0
j
U C F.
APPLICANT: I f. a:�t n V 7 i 3 4 N 5�'Z�
. INOTR-1- TO AP —
h,-)uld becc�rn� su!'iLs 1 --il�
I in p t LU
CompensDtv)n prw.i_wns of the, t
C V- L E RVA L I D AT ON
wi 111 ctmip!, with �uch pro',`..'
deemed re vol;rd. I-L-, R V I T Y
L I CONTi�A(.'j O�.
I htreb-' affirp! 0i.: jn- hcen,1�13' c E 1; N i T
ne,s and -j i rn ht.�n�, i-
t e3'ect.
Lictri.st Nii--n�r-- I
tor
em zae. t f._;m ihe li
I L
licens'-d architect or a r Cog: e 7 d Nn achec,- I;e� —15of a!):)ve.
acting .'n mv profe�-ior,2.1 camifiivp• -1:3:.
ill—'s an'i Cod ) FEE
i TOTAL FEE 7".
H,'-).'\'r-- OV.-N ER-BUILT"l-z il.. !:.I-i L
I hereli)- affirrn Sr t I am
License Law f
nes,and Plofv'si-;Is Code):
i. Lis ovnt- of iji-,, proj,L,-it. v.-W
'TEL. NC.
n0i
I. as owner of the p.operi) a,!-.
with licen-sej contractors ;o cit:.;.. ' C,C.,C)r 1
(Section 1,044. Business a
�z
`A
TEL. r! 4 4 5 6C
CON57 I21_ICI ION LLNCW,'G A-;
n'
I hereby affirin th�i- thee k, �e
7 S A
for the pciforni�wce of the wof'�; fo! vil%�"
issued (Src. 30i=7. Ci,.C.).
Lender's Nanne
Lender's AddTes,
TEL. N,0.
",j.ve re-,id
above illfo-illn! qZ r CL-.SS-
ordlinLnc,s -,ind
A;. C",1'.d;1 i r -111 J h F,b U t:-''JI-i I
-N A N A TO 11,Y L -N
COUnt'. to
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