HomeMy Public PortalAbout9657 LAS TUNAS DR_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0308070005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
L ES D BUILDING 9657 LAS TUNASDRTR: 65611 LT: 136
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802103
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: KAUFFMAN
8587-020-019 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY
41 VENTILATION FAN 3.00 FAN 47.25
TENANT: TOTAL FEES 75.00 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES 0 :
08/07/03 JK 02/03/04
OWNER: TEL. NO: FIN TE FINAL BY: CODE:
N C HOA (626) 448-8586-
4016 CLARK AVENUE ZJ
EL MONTE 91731 DESCRIPTION OF
INSTALL 2 EXHAUST FAN ONE AIR CURTAIN
APPLICANT: O:
TAI-SHIU POOH (626) 571-6752-
838 DE LA FUENTE SPECIAL CONDITIONS:
MONTEREY PARK 91754
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
TAI-SHIU POON (818) 410-4088-
838 DE LA FUENTE LIC. NO AC
MONTEREY PARK CA 91754 444436
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
LIC. NO: AC/COMPRESSOR
THERMOSTAl
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508
c .WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT
I hereby affirm that I have a certificate of consent to self
insure, or a certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING
.or a certified copy thereof(Sec. 3800, Lob. C.) 76A364C
fi� I / CE-81 (REV. 10/81)
Policy No. 1 i 1 CompanY�f„/'' tYf'vim r- 'V r /1f .f f�?�7f�r��
Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING �� r l
tion depart m nt. 1 (PRINT OR TYPE ONLY) ADDRESS 17 j ,r
Date Applicant tf6 LOCALITY ./ ry
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE '
CERTIFICATE OF EXEMPTI�N FROM WOR RS' NEAREST
COMPENSATION INSURANCE CROSS ST.
(This section need not be completed if the work involved by ABSORPTION UNIT,BTU ,/ 5 DISTRICT NO PROCESSED BY
the permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM Ile'.)')a /
I certify that in the performance of the work for which this C C W
permit is issued, I shall not employ any person in any manner BOILER,BTU
so as to become subject to the Workers'Compensation Laws. // f'r �(�f APPROVALS DATE INSPE OR'S SIGNATURE
Date Applicant COMPRESSOR, BTU_!�%G7, � 16 vV ROUGH
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL 7C$
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATION
with comply with such provisions or this permit shall be /�
deemed revoked. FURNACE: FAU GRAVITY lfL �/2
LICENSED CONTRACTORS DECLARATION FLOOR BTU V
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED—UNIT—
(commencing
USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect. IL
7T7 do
Lic. Class
License Number � / � ® kP
Contractor r A,4IRLJA% Date
❑ I am exempt under Sec.
Plan check fee ®-
BAP.C. for this reason PERMIT ISSUING FEE$ S
ate:
Signature-61 `� TOTAL FEE
NER-BUILDER DECLARAT 4 PLAN CHECK APPLICANT
I hereby affirm hat I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and NAME
Professions Code): Q A
❑ I, as owner of the property, or my employees with ADDRESS
o 0 0 0 o f?•
wages as their sole compensation,will do the work and CITY TEL. NO.
the structure is not intended or offered for sale(Section 0 0 30.5 0
7044, Business and Professions Code).
OWNER t �f .i � �
❑ I, as owner of the property, am exclusively contracting l— 0 0 0 J LA 5 Q
with licensed contractors to construct the project (Sec- MAIL
tion 7044, Business and Professions Code). ADDRESS ,
CONSTRUCTION LENDING AGENCY CITY 8UrbWt/ .7 TEL. NO.Ave
— 5
I hereby affirm that there is a construction lending agency for UL
the performance of the work for which this permit is issued CONTRACTOR ,
(Sec. 3097, Civ. C.). . '12W Avviahlk-45; U16,
ADDRESS 11J.Z4t
Lender's Name
CITY ..� EL. NyJI v ''
Lender's Address
STATE I LIC.
I certify that I have read this application and state that the LICENSE NO. CLASS 12
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
up ngthe oWVe entioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of App icant o ent Date