HomeMy Public PortalAbout5517 NOEL DR_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0806090003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 9180
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
5517 NOEL DR
ON FILE FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802318
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET BROADWAY
5387 026 003 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl
102 COMPRSR < 100 KBTU 1 00 COM 27 00
TENANT TOTAL FEES 54 75 JISSUED ON PROCESSED BY PLAN BY EXPIRES ON
06/10/08 SR 12/07/08
OWNER TEL NO FINAL DAW FINAL BY CODE
lQUACH PHUONG (626) 712 3914 i I��%%'� p
5517 NOEL DR
TEMP 917802318 IDDESCR PTION OF WORK
REPLACE A/C UNIT
APPLICANT TEL NO
ICHEN (626) 712 3914
5517 NOEL DR ISPECIAL CONDITIONS
TEMPLE CITY CA 91780
CONTRACTOR TEL NO JAPPROVALS DATE INSPECTOR SIGNATURE
IJACKY CHEN (626) 712 3914 1 1
5517 NOEL DRIVE LIC NO JFAU/WALL FURNACE
TEMPLE CITY CA 91780 NONE
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER TEL NO IDUCT WORK
LIC NO JAC/COMPRESSOR
THERMOSTAT �I
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
REPORT ID DPR264 ROUTE TO BS0508
WORKERS COMPENSATION DECLARATION APPLICATION FOR PERMIT
I herAby affirm that I have a certificate of consent to self
orsar erttir a ified coifscate of thereof Workers
e38M Lob tion Insurance 76A3� HEATING VENTILATING AIR CONDITIONING
PY ( ) 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 (PRINT OR TYPE ONLY) ADDRESS J Y)
r7 AW
Date Appl icanf LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WORKERS NEAREST
COMPENSATION INSURANCE 1 CROSS ST
(This section need not be completed N the work involved by ABSORPTION UNIT BTU DISTRICT NO _/ PROCESS BY
the permit is For one hundred dollars($100)or less) AIR HANDLING UNIT CFM V G
I certify that in the performance of the work for which this
permit is Issued I shall not employ any person in any manner BOILER BTU
so as to become subject to the Workers Compensation Laws APPROVALS DATE I S ORSSIG TURE
Date %" pplicant � 411�7 COMPRESSOR BTU ROUGH
NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM FINAL
Exemption you should become subject to the Workers
Compensation provisions of the Labor Code you must forth EVAPORATIVE COOLER VALIDA 1 N
with comply with such provisions or this permit shall be
deemed revoked FURNACE FAU GRAVITY
LICENSED CONTRACTORS DECLARATION I FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED-UNIT-
(commencing
USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business HEATER WALL
and Professions Code and my license is in full force and effect "OD 6V �`W
License Number Lic Class rC/1�� V
Contractor Date
❑ I am exempt under Sec 13
Plan check fee IL
B 8P C for this reason in
PERMIT ISSUING FEE$ Z
Date
Signature TOTAL FE ,_TT 8 4 211 A
OWNER BUILDER DECLARATION PLAN CHECK APPLICANT # e • • • • 8
1 hereby affirm that I am exempt from the Contractor s License Poo Law for the following reason (Section 7031 5 Business and NAME e e 2(1 5 Q
Professions Code)
I as owner of the property or my employees with ADDRESS • • - 20509
wages as their sole compensation will do the work and
the structure is not intended or offered for sale(Section CITY TEL NO ( 124-87
7044 Business and Professions Code)
OWNER � 1L
El as owner of the property am exclusively contracting MAIL C
with licensed contractors to construct the project (Sec ADDRESS AY,
tion 7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY CITY f Lt �/ TEL NO '+
I hereby affirm that there is a construction lending agency for L ,
the performance of the work for which this permit is issued CONTRACTOR
(Sec 3097 Civ C)
ADDRESS
Lender s Name jA
L NO
Lender s Address CITY
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 jaws relating to building construction
and bya re yEsentatives of this County to enter
u tfi d r rty for inspection puurposes7 SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date