HomeMy Public PortalAbout6228 MUSCATEL AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0511140016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 6 UN: .002 6228 MUSCATEL AV N
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: SGAB CA 917752627
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5386-010-012 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
41 VENTILATION FAN 1.00 FAN 15.75
TENANT: TOTAL FEES 43.50 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
11/14/05 JK 05/13/06
OWNER: TEL. NO: FIN AT8 FINAL BY: CODE:
CEO, DENNIS (626) 292-6921- `
6228 MUSCATEL AV ir7aV oc_
SGAB 917752627 _RS R PTION OF WORK
VENTILATION FAN
APPLICANT: TEL. NO:
TSUSHIMA -
317 W. MAIN ST #417 SPECIAL CONDITIONS:
ALHAMBRA, CA 91801
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
MAR GERALD WAYNE (626) 646-1988-
8835 EMPEROR AVENUE LIC. NO FAU/WALL FURNACE
SAN GABRIEL, CA 91775 4392978
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
TSUSHIMA, RICK K (626) 282-3417- g
317 W MAIN ST #417 LIC. NO: AC COMPRESSOR G
ALHAMBRA, CA 91801 4392978
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
* ADDITIONAL DATA ON FILE
REPORT ID: DPR264 ROUTE TO: BSO508
76A36/111- CEBIBSI-9i75 APPLICATION FOR'PERMIT
HEATING - VENTILATING - AIR CONDITIONING
BUIL G AND SAFET IVISION 41
FOR APPLICANT TO FILL IN BUILDING IClZ7 M U, L
(PRINT OR TYPE ONLY) DDRESS
LOCALITY
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ;NEAREST
CROSS ST.
ABSORPTION UNIT, BTU __
OWNER SOLL9K30 ME
AIR HANDLING UNIT, CFM MAILfln -^
ADDRESS MV .P7 l
BOILER, BTU CITY ,3 6,pr,%R I L_ TEL. NO.; 4g+
COMPRESSOR, BTU CONTRACTOR J?jp , P
o -
VENTILATION SYSTEM ADDRESS a
EVAPORATIVE COOLER CITY Az V SIATEL. NO. 3 9I
J FURNACE: FAU GRAVITY STATE J �j LIC.
/ FLOOR BTU IZ2do LICENSE NO. L�%+7�IDC> CLASS
�-
HEATER: SUSPENDED-'UNIT- DISTRICT NO. GROUPZONE OCESSED BY Q-
WALL
x • 08 "Y
Y 7ib''� S. C]
INSPECTION RECORD w
• LL
ys Z
Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE
` PLAN CHECK APPLICANT
NAME
ADDRESS
al
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, VENTI-
LATING, AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION - APPROVALS DATE' INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISIO! OF THE BUSINES ND PROFESSIONAL
CODE OF THE STATE 0 C L RN A. ROUGH
ROUGH
SIGNATURE FINAL
OF PERMITTEE "'j �t°•
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION M.O. ASH.
2:6'4,Ll SFp '21 411 0 2_0.OA98 A
76A364C .
CE-818 TRIM.6/78) r
®> APPLICATION FOR PERMIT
HEATING - VENTILATING AIR -CONDITIONING
COUNTY OF LOS ANGELES DUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDIN
(PRINT OR TYPE ONLY) ADDRES
NO. TYPE OF APPLIANCE OR EQUIPMENT 'FEE LOCALITY 'r
NEAREST n 1
• CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS ���
BOILER,BT
' CITY TEL O 1
COMPRESSOR,BTU CONT CT ryl
VENTILATION SYSTEM
ADDRES
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU GRAVITY STATELIC. a.
FLOOR BTU LICENSE NO. CLA r�
HEATER: SUSPENDED UNIT_
WALL pppgOVALS DATE INSPECTOR'S SIGNATURE
ROUGH
FINAL j>� __—�. O
INSPECTION RECORD
mg
10
Plan check fee 25 of above.
PERMIT-ISSUING FEE$ 71.— Ila
TOTAL FEE O�
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME V ^,T
ADDRESS � p
CITY TEL.NO.
�2047A
IHEREBY ACKNOWL T T I HAVE READ THIS APPLICATION AND
STATE THAT THE ABO IS COR ECT AND EE TO COMPLY WITH ALL # o 0 o o 4 1
ORDINANCES AND LAWS R ULATING E ING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION 2 0 - 27,00
I HEREB!! ER THAT I'AM CTING IN VIOLATION OF
CHAPTER 9,/D N THE BUSI SS AND PROFESSIONAL CODE 2 7 O O U
OF THE STA? F C IA. o.0 0
SIGNATU
OFPER. t� O
�'-
•�' 011,03'-79
DISTRICT NO-. /� PROLE ED BY
Lp
�/
ION
WORKER'S h have
certificate
of consent to 7SM63DPW9189 APPA ATION FOR PERMIT LIME GREEN
7tiA364C
I hereby affirm that I have a certificate of consent to self insure,
or arcertificafe of Worker's Compensation Insurance, or a certifi�e� • e HFATING 1VENTILATING-AIR CONDITIONING
copy thereof(Sec�y3800MLab.C.)
Policy N fr 9,`� Compan
. y COUNTY OF LOS ANGELES 'DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
❑ Certified copy is hereby furnishe'.
y p FOR APPLICANT TO FILL IN BU LDING
Certified copy Is filed with the count 692
Idin ns action AD
L`RESS
department. (PRINT OR TYPE ONLY)
Date - Applicant NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST.
COMPENSATION INSURANCE ABSORPTION UNIT,BTU
- ASSSR
(This section need not be completed if the work Involved by the M P BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to BOILER,BTU I7®
become subject to the Workers'Compensation Laws. �
J x
COMPRESSOR,BTU �
APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of ROUGH
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code,you must forthwith comply with such FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY VALIDATION
LICENSED CONTRACTORS DECLARATION FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
(commencing with Section of Division 3 of the Business and WALL
Professions Code,and my license is in full force and effect.
License Number Lic.Class .3W,3 �'•'
_ f i I EMo.
Contractor Date �+ �J I}I i � o '
❑ I gexempt under Sec. Plan check fee r• —r•: �� �,_�
B.&P.C.for this reason PERMIT ISSUING FEE$ d:q +��HAN �!e I.Q
Date: CHANGE .II�
TOTAL FEE LL
Signature c'
PLAN CHECK APPLICANT
cr
OWNER-BUILDER DECLARATION + f12
1 hereby affirm that I am exempt from the Contractor's License Law NAME 1 tji 1113 19
for the following reason (Section 7031.5, Business and Professions
Code): ADDRESS
❑ 1, as owner of the property, or my employees with wages
as their sole compensation, will do the work and the CITY TEL.NO.
structure is not intended or offered for sale (Section 7044,
Business and Professions Code). OWNER �. LWAW ®� %ice
❑ I, as owner of the property, am exclusively contracting MAIL ,�1
with licensed contractors to construct the project (Sec- ADDRESS SA 1J.
tion 7044,Business and Professions Code).
CITY TEL.NO.
CONSTRUCTION LENDING AGENCY �J
I hereby affirm that there is a construction lending agency for CONTRACTOR ,
the performance of the work for which this permit Is issued
(Sec.3097,Civ.C.).
ADDRESS
Lender's Name
CITY TEL.NO.
Lender's Address �/� 'i
I certify that I have read this application and state that the above LICENSE NO. Tr 3a 70 CLLASS
information is correct. I agree to comply with all County ordinances
a State laws relating to building construction,and hereby authorize
repro ntatt is County to enter upon the above-mentioned
proper y fo n p tion r r SEE REVERSE FOR EXPLANATORY LANGUAGE
SIG R OF PLICART OR AGENT DATE