HomeMy Public PortalAbout9677 LONGDEN AVE_Mechanical__ 7(�A364,,.�E 818 - 9-71 APPeATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES 'BUILDING
DEPARTMENT OF COUNTY ENGINEER ' ADDRESS
BUILDING AND SAFETY DIVISION ?LOCALITY +—
r NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAI L /
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY TEL. NO. O
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CIT TEL. N
COMPRESSOR, BTU .✓ S A E LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE SED BY
EVAPORATIVE COOLERCD
8 —/
TFURNACE: FAU—GRAVITY. INSPECTION REC v
FLOOR BTU
HEATER: SUSPENDED UNIT_ OF
W LL v
W
N
Z
Plan check fee 25% of above. See reverse.
PERJIIT ISSUING FEE S 3 00
fOTAI. FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATIN EATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
_ �_ t G►
I HEREBY CERTIFY TH AM NO A IN VIOLATION ROUGH
OF CHAPTER 9, DIVISION THE BUS E R ESSIONAL INAL �(: ��•
CODE OF THE STATE OF FORNIA. �•- d t'�
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE
PLAN CHECK VALU6AtION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76 A364 — CE ata — 9-71 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS _
BUILDING AND SAFETY DIVISION LOCALITY 3
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY TEL. NO. 7 O y
ABSORPTION UNIT, BTU
s CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL.
r Z COMPRESSOR, BTU &2d del -r 40 ST T ff LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE OCEBBED BY
EVAPORATIVE COOLER 3O d
FURNACE: FAUGRAVITY IJ J v
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT_ o
WALL v
W
�• DO z
eo
Plan check fee 25c of above. See reverse,
PERMIT ISSCI\G FEE S 3 00
OTAI. FEFZO— Z—
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND'LAWS REG UL G HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
I HEREBY CERTIFY TH AM A NG VIOLATION
OF CHAPTER 9, DIVISION THE AND ROFESSIONA ; FINAL
CODE OF THE STATE OF IFORN
SIGNATURE PERMIT VALIDATION CK. M.0. CASH
OF PERMITT
PLAN CHECK IDATION CK, M.O. CASNv
j 5 01'011 -L04 2 D 4,/ ":1 r.:
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS'COMPENSATION DLCLARATION I CEA 818(2-80) APPLICATION FOR PERMIT
I hereby affirm that I have S certificate of consent to self i
insure, or a certificate of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING
"fl
a cert,;Oic copy there f(Sec.3800yj,ab. )
P tcy/)�4/0. G OZ Company3�
® Certified copy is hereby furnished.
COUNTY OF LOS ANGELES �" BUILDING AND SAFETY
Certified copy is filed with the county build' p' s tion FOR APPLICANT TO FILL IN BUILDING 17
7 E-44ZAQ14PAI
Date d $; Applicant o (PRINT OR TYPE ONLY)' ADDRESS /
LOCALITY1100,
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPENSATION INSURANCE NEAREST
(This section need not be completed if the work involved ABSORPTION UNIT,BTU CROSS ST. a
by the permit is for one hundred dollars (5100) or less.) DISTRICT NO. P OCESSED BY ti V
1 certify that in the performance of the work for which this AIR HANDLING UNIT,CFM �' 'y �/
permit is issued, I shall not employ any person in any manner 0 J IJ d O
so as to become subject to the Workers' Compensation Laws. BOILER, BTU
APPROVALS DATE INSPECTOR'S SIGNATURE V
Date Applicant COMPRESSOR,BTU ROUGH 7 O d
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL �°�' - Z
Exemption, you should become subject to the Workers'
,Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATION
with comply with such provisions or this permit shall be
emed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR: BTU �Q
rihereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT /
9 (commencing with Section 7000)of Division 3 of the Busi- WALL �U6
ness and Professions Code, and my license is in full force and p ��
effect,
License Number V J Lic.Class s� -Z a
Contractor " / _ /`f'��� OF
IDI am exemp from the licensing requirements as I am a
licensed architect or a registered professional engineer Plan check fee 25%of above.
acting in my professional capacity (Section 7051, Bus- r/
iness and Professions Code). PERMIT ISSUING FEE$ d
Lic,or Reg.No. Date TOTAL FEE ,S�d
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from- the Contractor's NAME
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code): ADDRESS
I, as owner of the property, will do the work and the 5 G�, 1 A
structure is not intended or offered for sale (Section CITY TEL.NO.
7044,Business and Professions Code). -I-- / -" 0 0 0 0 0 0
❑ I, as owner of the property, am exclusively contracting OWNER -
with licensed contractors to construct the project AIL � (�` 2 o 0 1 6 5 0
(Section 7044,Business and Professions Code). ADDRESS V/ C�
CONSTRUCTION LENDING AGENCY -CITY TEL.N . 0 0 c c ('
I hereby affirm that there is a construction lending agency ' ' —C
for the performCONTRACTOR performance of the work for which this permit is �� S/IV
issued(Sec.3097,Civ.C.). ` A
Lender's Name ADDRESS .76 EOY U
Lender's Address CITY , EL.NO.
I certify that I have read this application and state that the STATE Z LIC.
above information is correct.I agree to comply with all County LICENSE NO. ��/ CLASS
ordinances and State laws regulating Heating, Ventilating and
Air Conditioning,and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter u on Ite ve-mentioned property for
insp do purpose.
Signature of Pe;We 7 Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1004220014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ON FILE I 1 9677 LONGDEN AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917801457 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
15383-019-009 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, C
1 102 COMPRSR < 100 KBTU 2.00 COM 54.00 [
(TENANT: 108 FURNACE/HEATER <100 2.00 UNI 54.00 TISSUED ON: PROCESSED BY: PLAN BY: 1
1 I TOTAL FEES 135.75 104/22/10 SR 1
(OWNER: TEL. NO: FjXAJk DATE FI BY: CODE: 1
ITEMPLE BETH DAVID (626) 287-9994- 1 [ � 1
19677 LONGDEN AV
ITEMP 917801457 IDESCRIPTION OF WORK 1
1 1 1HEATING & AIR CONDITIONING IHA E OUT 1
(APPLICANT: TEL. NO: I I I
IDUGAN (760) 716-2281- 1 1 1
132528 SUNNYVAIL CIR. I ISPECIAL CONDITIONS:
ITEMECULA, CA 92592 1 1
ICONTRACTOR: TEL. NO: 1 [APPROVALS DATE INSPECTOR SIGNATURE 1
IDUGAN HEATING AND AIR CONDITIONING (760) 716-2231- 1 [
132528 SUNNYVAIL CIRCLE LIC. NO I 1FAU/WALL FUR= 1 1
ITEMECULA, CA 92592 907192 C20 1 1 6 1
1 1 ICOMBUSTION AIR OPENINGS [ I
I I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 [DUCT WORK
I LIC. NO: 1 1AC/COMPRESSOR 1
I
I
(THERMOSTAT 1
1 I IFIRE DAMPERS I I
I I I I
1 ISMOKE DETECTION DEVICES 1
1 1 [COMMERCIAL HOOD
I 1 1 I
[ I I [ [
[ I I [ I
I I I I I I
I I i I I I
IREPORT ID: DPR264 ROUTE TO: BS0508 I 1 I I
[ I [ I [ I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0208080009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 9170
PHONE: (626) 285-0488 EXT:
LEGAL ID: S PAID BUILDING
ON FILE 9677 LONGDEN AV
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917801457
ASSESSOR INFOR14ATION NEAREST CROSS STREET: KAUFFMAN
5383-019-009 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
41 VENTILATION FAN 2.00 FAN 31.50
TENANT: TOTAL FEES 59.25 ISSUED 0N: PROCESSED : PLAN EXPIRES ON:
08/08/02 JK 02/04/03
OWNER: TEL. NO: FINAL BY: CODE:
TEMPLE BETH DAVID (626) 287-9994-
9677 LONGDEN AV EE X71 RE
TEMP 917801457 DESCRIPTION-OF W0
INSTALL NEW VENTILATION FANS
PPL NO:
SEAN CURRAN (626) 443-9984-
10920 GRAND AVENUE SPECIAL CONDITIONS:
TEMPLE CITY s _"
CONTRACTOR: TEL. NO: s`•`f:;r +• % APPROVALS DATE INSPECTOR SIGNATURE -----
SC
IG ATURESC CONSTRUCTION (626) 443-9984-
10920 GRAND AVENUE LIC. NO FAU ALL FURNACE
TEMPLE CITY, CA 91780 805476 B
` '•,: _` \ ` t COMBUSTION AIR OPENINGS
ARCHITECT ENGINEER: TEL. NO:
DUCT WORK
I,
LIC. NO: - AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
• 1 -� - _
SMOKE C O DEVICES
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508