HomeMy Public PortalAbout10519-10520 OLIVE ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1209240012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
1BK: 224 PG: 98 PC: 1 I 1 10519 OLIVE ST 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802865 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: [
18586-029-048 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl
1 141 VENTILATION FAN 3.00 FAN 47.40 1 1
[TENANT: TOTAL FEES 75.20 ISSUED ON: PROCESSED BY: PLAN BY: [
I 109/24/12 SR 1
(OWNER: TEL. NO: I IFI DATE FINAL BY: CODE:
ICHEN, TIM (626) 379-1611- 1 1
110519 OLIVE ST I I /('72 1
ITEMP 917802865 I DIMCRIPTION OF WORK
I I (REPLACE 3 VENTILATIONS FANS
(APPLICANT: TEL. NO: 1 I
TSH CONSTRUCTION & DEVELOPMENT (626) 688-6255- 1 1
15605 TEMPLE CITY BL. 1 SPECIAL CONDITIONS: 1
(TEMPLE CITY CA 91780 I I
I I I I
ICONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1
TSH CONSTRUCTION AND DEVELOPMENT (626) 688-6255- 1 I
15605 TEMPLE CITY BLVD. #B LIC. NO IFAU/WALL FURNACE I I I
[TEMPLE CITY, CA 91780 952913-B I I I I I
I 1 ICOMBUSTION AIR OPENINGS I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 IDUCT WORK I I I
I LIC. NO: 1 IAC/COMPRESSOR I 1
1 I ITHERMOSTAT
I I IFIRE DAMPERS 1
I I I I I I
ISMOKE DETECTION DEVICES I 1
1 I (COMMERCIAL HOOD I I
I I I4erAAAI�
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IREPORT ID: DPR264 ROUTE TO: BS0508 I I 1 I
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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, �iE��1�IG - VENTILATING - d11R CONDITIONING
or a certifies copy thereof (Sec. 3800, Lab. C') { 70 64C
ZO(i046 DPW 9/88
Policy No. Company
I
❑ 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 G G GZ
Date Applicant NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST
COMPENSATION INSURANCE CROSS
(This section need not be completed If the work Involved by ABSORPTION UNIT, BTU DISTRICT NO. PROC ED BY
the permit is for one hundred dollars (5100) or less.) /�� /�{/
I certify that in the performance of the work for which this AIR HANDLING UNIT, CFM `7
permit is issued, I shall not employ any person in any manner v
so as to becomes subject to the Workers'Co pensation Laws BOILER, BTU 4; APPROVALS DATE INSPECTOR'S SIGNATURE
""' �'� /v' ��C GCL�I'tT7 COMPRESSOR, BTU 'Tr{ t'/ .l=G ROUGH
to Applicahi� ,
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL
I Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER V I T
with comply with such provisions or this permit shall be deem-
ed revoked. FLOOR FURNACE:
FAU BTU ✓ 6
LICENSED CONTRACTORS DECLARATION
Al no—
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. ' .300011
O
License Numbs ic. Class ' ® U
Contract Date
❑ I am exempt under S c. U
Plan check fee w
B.&P.C. for this reason PERMIT ISSUING FEE $ U
Date: Z
Signature TOTAL FEE 3
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and NAME
Professions Code):
ADDRESS
El 1, as owner of the property, or my employees with 4,�r- x.
wages as their sole compensation,will do the work and 9'
NO.
the structure is not intended or offered for sale(Section CITY TEL.
7044, Business and Professions Code).
OWNER �:
❑ I, as owner of the property, am exclusively contracting `r E—.0
with licensed contractors to construct the project (Sec- MAIL a a t ;�
tion 7044, Business and Professions Code). ADDRESS '0 4 hL 93 o DO
CONSTRUCTION LENDING AGENCY CITY TEL. NO. -• rrr•/ y'; tl'r
I hereby affirm that there is a construction lending agency for :•hCG + °-
the performance of the work for which this permit is issued CONTRACTO
(Sec. 3097, Civ. C.).
ADDRESS L s L �-
Lender's Name E 9
ESTATE
L. NO -ILender's AddressI certify that I have read this application and state that the '7 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
upon t above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Sign dire of pplicant or Agent Date