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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1307220034
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
1 ON FILE I 1 6339 OAK AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917801336 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
15382-017-031 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
I 102 COMPRSR < 100 KSTU 1.00 COM 27.00 1
(TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: 1
130 AIR INLETS/OUTLETS 4.00 UNI 17.60 107/22/13 SR 1
I 141 VENTILATION FAN 1.00 FAN 15.80 1 I
(OWNER: TEL NO: I TOTAL FEES 115.20 FINAL.,PA7E FINAL BY: CODE: 1
[CHAN, CHO SEE (626) 262-1821- i 1
16339 OAK AV
TEMP 917801336 DtSCRIPTXdN OF WORK
I I (INSTALL A/C & HEATING SYSTEM, 4 AIR INLETS AND 1 VENTILATION[
I I (FAN FOR A NEW 2ND: UNIT 1
(APPLICANT: TEL. NO: 1 I
IVAN, STEVEN (626) 675-7052- I
11798 GIGAR TERR 1 SPECIAL CONDITIONS: 1
IWEST COVINA CA 91792 1 I
I I 1
ICONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1
1DATKAM CONSTRUCTION, INC. (626) 675-7052- 1 1 1 AI
11798 GIGAR TERRACE LIC. NO 1 1FAU/WALL FURNACE 1 I
IWEST COVINA CA 91792 859760 1 1 I
ICOMBUSTION AIR OPENINGS
[ARCHITECT OR ENGINEER: TEL. NO: [ IDUCT WORK 1 I 1
ILEE, PETER (626) 280-9000- 1 1 I
18748 E VALLEY BLVD SUITE L LIC. NO: I IAC/COMPRESSOR I I
ROSEMEAD CA 91770 859760
(THERMOSTAT
1 (FIRE DAMPERS
SMOKE DETECTION DEVICES I I I
I I ICOMMERCIAL HOOD
I I I
I I I I I I
I I 1 I I 1
I I I E I
I I I 1 I I
1 I i I I I
I I I I I
I 1* ADDITIONAL DATA ON FILE
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I IREPORT ID: DPR264 ROUTE TO: BS0508 1 I I
I I I I I
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1403120022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I HIIILDING ADDRESS: I
ON FILE I I 6339 OAK AV I
IFEE DESCRIPTIO&:. QUANTITY: UOM: AMOUNT:( TEMP CA 917801336
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET:
15382-017-031 01 PERMIT ISSUANCE 'FEE
.' 27.80 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
1 141 VENTILATION FAN 2.00 FAN 31.60 1 1
ITENANT: I TOTAL FEES 59.40 ISSUED ON: PROCESSED BY: PLAN BY:
1 1 103/12/14 SR
(OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: ]
ICHAN, CHO SEE (626) 262-1821- ] 1 1
16339 OAK AV 1 1
(TEMP 917801336
I DgSCRIPTION OF WORK ]
I I REPLACE 2 VENTILATION FAJ FOR BATHROOMS REMODEL
(APPLICANT: TEL. NO: I I
IVAN, STEVEN (626) 675-7052- ] I
11798 GIGAR TERR I ISPECIAL CONDITIONS:
(WEST COVINA CA 91792
I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ]
IDATKAM CONSTRUCTION, INC. (626) 675-7052- 1 1I 1 1
11798 GIGAR TERR LIC. NO ] ]FAU/WALL FURNACE
IWEST COVINA CA 91792 859760 I 1 I 1
] 1 ]COMBUSTION AIR OPENINGS I 1
1ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I I I
I LIC. NO: i IAC/COMPRESSOR I 1 ]
(THERMOSTAT I I ]
1 i IFIRE DAMPERS
I I (SMOKE 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
I I I I I
I I I I I I
I I I I I
IREPORT ID: DPR264 ROUTE TO: BS0508 ] 1
I I I ] I
YORKER'S COMPENSATION
certificate
of consent to �M364CPW9/89 APPLICATw0N FOR PERMIT LI EGRE EN
I he:Fiby affirm tha},I have a certificate of consent to self insure,
or a certificate of vJDrker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING
copy thereof(Sec.3800 Lab.C.)
PPoliccy,No '�L° /SE'S- lcEompany COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
LJ Certified cro I�iereby furnished.
❑ C rtified copy is filed with t county building in pection FOR APPLICANT TO FILL IN BUILDING ADDRESS &s 39E
d part ant. (PRINT OR TYPE ONLY)
Date Applin t LOCALITY (F
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
IFICATE OF EX PTI N FROM WORKERS' CROSS ST.
COMPENSA INSURANCE ABSORPTION UNIT,BTU
SOR
(This section need not be completed if the work Involved by the MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to BOILER,BTU
become subject to the Workers'Compensation Laws. /��y�) �� �✓LGd Gam+.-�
COMPRESSOR,BTU
M� APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant f!1 VENTILATION SYSTEM ` W
NOTICE TO APPLICANT: If, after making this Certificate of G ROUGH
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code,you must forthwith comply with such FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION l FLOOR BTU��D� ' V A 'ION
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED-UNIT-
(commencing
USPENDED UNIT ad
(commencing with Section 7000)of Division 3 of the Business and HEATER: WALL
Professions Code,-and my license is in full force and effect.
License Number �2 Lic.Class
y� j a
Contractor A k-T"'"r/ Date C
❑ I am exempt under Sec. Plan Check fee d�! Lsv C
EE$ C
B.&P.C.for this reason PERMIT ISSUING F 3 ftp F
Date: TOTAL FEE u
Signature G
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
1 hereby affirm that I am exempt from the Contractor's License Law NAME
for the following reason (Section 7031.5, Business and Professions
Coe): ADDRESS ^-
I. 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 Arm J e --"J
1, as owner of the property, am exclusively contracting MAIL A � II�TfiL_ 37 a 00
with licensed contractors to construct the project (Sec- ADDRESS iJ AJ _ _ ,
tion 7044,Business and Professions Code). /� �•;iEX. •_)_
CONSTRUCTION LENDING AGENCY CITY /c lG TEL.NO.;? . �+�1 _
I hereby affirm that there is a construction lending agency for CONTRACTOR v:IRi114L °-�_
��
the performance of the work for which this permit is issuedA
(Sec.3097,Civ.C.). ADDRESS
Lender's Name .` J
CITY B�IJ L TEL.NO.
Lender's Address STATEp, LIC. e 1
1 certify that I have read this application and state that the above LICENSE NO. 2 rJ CLASS � b,
information is correct. I agree to comply with all County ordinances
and State laws relating to building construction,and hereby authorize
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ter upon the above-mentioned
SEE REVERSE FOR EXPLANATORY LANGUAGE
CN RE OF APPLICANT OR AGENT U DATE