HomeMy Public PortalAbout9328 OLIVE ST_Mechanical__ COUNTY OF LOS hNGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1010250010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID 1 BUILDING ADDRESS: I
ITR: 11492 IT: 5 BL: B 1 9328 OLIVE ST
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803127
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ALESSANDRO
18590-002-005 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl
I 141 VENTILATION FAN 1.00 FAN 15.80 1
(TENANT: I TOTAL FEES 43.60 ISSUED ON: PROCESSED BY: PLAN BY:
10/25/10 SR
TOWNER: TEL. N0: I IF AL DATE FINAL BY: CODE:
I
1MAGNI JUAN C;ANGELICA M (626) 484-1673- I I
9328 OLIVE ST
ITEMP 917803127 I DESCRIPTION OF WORK
VENTILATION FAN FOR NEW BATHROOM
1APPLICANT: TEL. NO:
IMAGNI, JUAN (626) 484-1673- I I
SPECIAL CONDITIONS:
I
(CONTRACTOR: TEL. NO: I +APPROVALS DATE INSPECTOR SIGNATURE
IMAGNI, JUAN (626) 285-9105- I 1I I I
19328 OLIVE ST. LIC. NO IFAU/WALL FURNACE
ITEMPLE CITY, CA 91780 NONE
I (COMBUSTION AIR OPENINGS T I I
1ARCHITECT OR ENGINEER: TEL. NO: I (DUCT WORK 1 I I
I LIC. NO: 1 1AC/COMPRESSOR I 1 I
ITHERMOSTAT I 1
IFIRE DAMPERS I I I
ISMOKE DETECTION DEVICES I I I
COMMERCIAL HOOD
I I I
I I I I I
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I I I I I I
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IREPORT ID: DPR264 ROUTE TO: BS0508 I I I I
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APPLICATION FOR PERMIT ',__7e
GA364_CEB18_8_68 ' HEATING - VENTILATING - AIR CONDII'IONIN.
~ COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING "
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE; COUNTY ENGINEER
'COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING .; LOCALITY
FOR APPLICANT TO FILL IN GROSSEST.
(Print or type only) ,
OWNER
NO.. TYPEJOF APPLIANCE OR EQUIPMENT FEE MAIL
ADDRESSA& e i2d& Ai±&
ABSORPTION SYSTEM, BTU CITY TEL. NO. g
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS 1,001
COMPRESSOR, HORSEPOWER CITY TEL. NO. d
STATE LI C.
VENTILATION SYSTEM LICENSEf NO. CLASS
I DISTRICT NO. GROG ZONE PROCESSED BY
EVAPORATIVE CLER
FURNACE: FAU G AVJTY - ✓ ` v /� '
FLOOR—BTU Q\9_v INSPECTION RECORD
HEATER:,SUSPENDED UNIT—
WALL
NIT WALL
CD
- H
V
I Z
NEW ADDITION PERMIT. $• 3 00 ,
ALTER—REPAIR— TOTAL FEE $ f
Plan chea applic t
Name "
,i.
Address l
City- og&A.. . Tel. No.
1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATI.ON
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- ; APPROVALS _ T PECTOR'S SI/NATURE
LATING,AIR CONDITIONING. `!
ROUGH V
I. HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION ;FINAL
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL00,
CODE OF THE STATW. CALIFOR. JACK R. ALLEN,SU RVISI ECHANICAL ENG'R.
SIGNATURE �C TtPERMIT VALIDATIO CK. M.0,
CASH
OF PERMITT
PLAN CHECK VALIDATION I
I fni 0 6 2. 9:o J& 8 4 11 D, '?.Q ;� 7-
IEE
.IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULEI
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT
I hereby,affirm that I have a certificate of consent to self I
insure, or a certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING
/gertified copy thereof (Sec. 3800, Lob. C.) 76A364C
(�(J � t CE-818(REV. 10/81)
P❑alicyNVo. R� 0 Company S4*0Zr`d2 /LMr K
Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy is filed with the county building ins ec- FOR APPLICANT TO FILL IN BUILDING `� /t u p�
tion department, q/v� (PRINT OR TYPE ONLY) ADDRESS d
Date _ Applicant `P- / NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY eAe e e/'
XV
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST. a
COMPENSATION INSURANCE CROSS ST. el'AI/ /
(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($100)or less.) AIR HANDLING UNIT,CFM C" 0
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner BOILER,BTU
so as to become subject to the Workers'Compensation,Laws. t L� APPROVALS DATE IN EC SIGN RE
` COMPRESSOR, BTU ROUGH
Date Applicant i , 1
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL
Exemption, you should become subject to the Workers' di
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATI
with comply with such provisions or this permit shall be
deemed revoked. FURNACE: FAU 4AVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU U
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
'(commencing with Section 7000)of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect. 916
>_
License Number! 03 733– Lic.Class` 0 U
X12-Contactor(2�NO� /2 Date z — U y
❑ 1 am exempt under Sec.
Plan check fee
B.&P.C. for this reason' � h
PERMIT ISSUING FEE$
• Date: S ;20902A
TOTAL FEE
Signature # 0 0 0 0 0 8
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractor's License Poo. 11 0 0 3 Q- 350
Law for the following reason (Section 7031.5, Business and NAME
Professions Code): 0 0 -.3 Q5 0't
'
❑ I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and CITY TEL. NO. I a 2
the structure.is not intended or offered for sale(Section
7044, Business and Professions Code). OWNER 2 JAS MAC N /�
El1, as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec- MAIL
ADDRESS 8 611�U
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITY Te �� tnr•Ae TEL. NO.128y..9/pJ_
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued CONTRACTOR e_V G r
(Sec. 3097, Civ. C.). �
ADDRESS 93 / � FAI
C r iU7,/
{
Lender's Name N !
CITY &�l � le/ `'e` TEL. NO. 0 -�-
Lender's Address STATE LIC.
I certify that I.have read this application and state that the LICENSE NO. 7 CLASS fc.10
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
u�the bove-menf tiio�ne perty for
•inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
u
/ 0 �r l
Signature of Applicant or Agent Date