HomeMy Public PortalAbout9708-9710 LONGDEN AVE_Mechanical__ "y 11, "
;6f►364Y ICE,1116Bh 9/77 APPLICATION FOR PERMIT
HEATING - VENTILATING - ADR CONDITIONING
BUIL�NSAFET (VISION
BUILDING
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) p T
ADDRESS 08- Longden
o den
LOCALITY Temple City
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER]I Weber D elopment
AIR HANDLING UNIT,CFM MAIL
ADDRESS 2 Te=le City
pL
BOILER,BTU CITY Temple City TEL.NO. 286-281 8
$ COMPRESSOR,BTU 3 Ton 20.00 CONTRACTOR Almic Heating & C Ino•
VENTILATION SYSTEM ADDREss2564 Maynard Drive
EVAPORATIVE COOLER CITY Duarte TEL.NO. 358-6851
2 FLOORCE: FAU BTUGR T;AqA— 2 .00 STATE LIC349239 CL C-2a
VVVVVV LICENSE NO. CLASS
HEATER: SUSPENDED UNIT— DISTRICT No GROUP 20NE PRO SSED BY
WALL /^
Upright Furnace 10-1—
��
INSPECTION RECORD IL
C �
0
Plan check fee 25% of above. id
PERMIT ISSUING FEE$ 7.00 w
TOTAL FEE 47.00 Z
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 REGULATING HEATING. VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT A TING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS D PROFESSIONAL CODE ROUGH
OF THE STATE OF ORNIA.
SIGNATURE FINAL ��
OF PERMITT
PLAN CHECK VALIDAT N CK. MO CASH
PE RM IT VALIDATION CK M.O. CASH
o
1 r -.1 o O
ION
WORKER'S I have
a certificate
of consent to 20.0046DPW 9/89 APPLICATION FOR PERMIT LIME GREEN,
78A964C
I hereby affirm that I have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING
co re,Qf(Sec.338800 Lab.C.)
popl�uL !S ompany— COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
❑ Certified copy is hereby furnished.
Certified copy is filed with the c uilding insp tion FOR APPLICANT TO FILL IN BUILDING
SS / ,� Q
department. (PRINT OR TYPE ONLY)
LOCALITY
Date_, —�I`5 Applicant
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION INSURANCE CROSS
ABSORPTION UNIT,BTU ASSESSOR
(This section need not be completed if the work involved by the MAP BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to BOILER,BTU
become subject to the Workers'Compensation Laws.
COMPRESSOR,BTU
APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of ROUGH
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER �n
provisions of the Labor Code, you must forthwith comply with such FINAL G?
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY I
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALID TION
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
(commencing with Section 7000)of Division 3 of the Business and WALL
Professions Code,and my license is In full force and effect.
License Numbs-96? Lic.Class
Contractor Ja/ - Date Y—,30-41/ C
❑ I am exempt under Sec. Plan Check fel a
a
BAP.C.for this reason PERMIT ISSUING FEE$ C*�t FC
-
Date: TOTAL FEE s ACCUL LL
Signature PLAN CHECK APPLICANT �°4 U.
OWNER-BUILDER DECLARATION 3307 48.1tl 2
1 hereby affirm that I am exempt from the Contractor's License Law NAME ® J,7VV
for the following reason(Section 7031.5, Business and Professions 1 IT 15
Code): ADDRESS
❑ I, as owner of the property, or my employees with wages TOTAL 48-R_!'�CD
as their sole compensation, will do the work and the CITY TEL.NO. CHECK
E
structure is not intended or offered for sale(Section 7044,
Business and Professions Code). OWNER l Amn AT9&wz,/4rJ CHANGE ° �)
❑ I, as owner of the property, am exclusively contracting MAIL tuv
with licensed contractors to construct the project (Sec- ADDRESS c=kfL4 /L 2 I t
tion 7044, Business and Professions Code). CITY TEL.NO. 2.!27.� `�L �- 1 /92
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency forCONTRACTOR ® rii�� 1 Ail �'-.15.1
the performance of the work for which this permit Is issued E✓C72�
(Sec.3097,Civ.C.).
ADDRESS f
Lender's Name �3 6/6/
6/
CITY_ , JVX TE O.
Lender's Address
I certify that I have read this application and state that the above LICENSE NO.. � �L CLLASS C
information is correct. I agree to comply with all County ordinances
and State laws relating to uilding construction,and hereby authorize
re tives of this unty to enter upon the above-mentioned
property for'nspectio purpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE
C - a�y c?_1 F APPLI ANT R AGENT DATE