HomeMy Public PortalAbout10708 LORA ST_Mechanical__ • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
ME 0508 1102170018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 17867 LT: 17 [ 10708 LORA ST 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803411 [
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18574-001-017 102 COMPRSR < 100 KBTU 1.00 COM 27.00 I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
1 108 FURNACE/HEATER <100 1.00 UNI 27.00 I I
[TENANT: 130 AIR INLETS/OUTLETS 1.00 UNI 4.40 JISSUED ON: PROCESSED BY: PLAN BY: 1
[ 101 PERMIT ISSUANCE FEE 27.80 102/17/11 SR [
I TOTAL FEES 86.20 1 I
[OWNER: TEL. NO: [ IFINAL DATE FINAL BY: CODE: [
ICHEN MARIE P (626) 286-0273- [ 1I
110708 LORA ST [ I� 1 ! I
ITEMP 917803411 I IDESCRIPTION OF WORK [
IREPLACEMENT OF EXISTING HVAC SYSTEM ]
[APPLICANT: TEL. NO: I ] I
IGUZMAN, JERREN (626) 616-4069- ] I 1
14331 CUTLER AVE [ i S119CIALI16
ITIONS:
[HALDWIN PARK 91706 [
]CONTRACTOR: TEL. NO: ] (APP VALS IDATE W6NSPECTOR SIGNATURE [
[AIR TRO INC. (626) 357-5311- 1 I I
11630 S MYRTLE AVE LIC. NO ] IFAU/WALL FURNACE [ I I
IMONROVIA, CA 91016 25822SC20 * ] I I I
I (COMBUSTION AIR OPENINGS I 1 I
[ARCHITECT OR ENGINEER: TEL. NO: 1 DUCT WORK I I
LIC. NO: i JAC/COMPRESSOR i [
THERMOSTAT
IFIRE DAMPERS I ] I
I I ISMOKE DETECTION DEVICES [ I I
I ICOMMERCIAL HOOD I [
I I I I I I
I I I I I I
I I I ] I I
1 ] I I ] I
I I I ] I ]
1 i* ADDITIONAL DATA ON FILE
REPORT ID: DPR264 ROUTE TO: BS0508
,. 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, Lab. C.) 76A364C
CE-818(REV. 10/81)
Policy No. Company
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
tion department. ADDRESS 00124 S/
(PRINT OR TYPE ONLY)
Date Applicant
LOCALITY. L� C--/.;— rye
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
7 4M
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION INSURANCE CROSS ST. L=/2—,$1,0W,5,nG A.'
(This section need not be completed if the work Involved by ABSORPTION UNIT, BTU DISTRICT NO �} PROCESSED BY
the permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM 3•S ���y 00 Q Jai
I certify that in the performance of the work for which this Cl
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. BOILER, BTU APPROVALS DATE INS ECTOR'S SIGN RE
Date ► pplicant COMPRESSOR,BTU ROUGH v
NOTICE TOAPPLICANT: If, after Making this Certificate of VENTILATION SYSTEM FINAL
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDAT N
with comply with such provisions or this permit shall be
deemed revoked. FURNACE: FA GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU 1600
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
'(commencing with Section 7000)of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect.
CL0
License Number Lic. Class ® tJ
Contractor Date 0
t°
❑ 1 am exempt under Sec. 4 1 6,8 A a
Plan check fee
B.&P.C. for this reason p # 0 0 0 0 0 8
PERMIT ISSUING FEE$
Date: TOTAL FEE f� 1 a 030.50
Signature
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT a a a 3 0.5 0 0
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and NAME ��= C -u 0 ,106-86
Professions Code):
I, as owner of the property, or my employees with ADDRESS lV Op. 2.45 917k0
wages as-their sole compensation,will do the work and
the structure is not intended or offered for sale(Section CITY �ay/�us �T?, TEL. NO.
7044, Business and Professions Code).
OWNER m _ 7 Cr U C
El 1, as owner of the property,am exclusively contracting
with licensed contractors to construct the project (Sec- MAIL
tion 7044, Business and Professions Code). ADDRESS
. CONSTRUCTION LENDING AGENCY CITY TEL. NO.
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued CONTRACTOR
(Sec. 3097, Civ. C.).
ADDRESS
Lender's Name
CITY TEL. NO.
Lender's Address
STATE LIC.
I certify that I have read this application and state that the LICENSE NO. CLASS
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
pan the a -mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
ignature of Applicant or Agent Date