HomeMy Public PortalAbout9420 OLIVE ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0005040026
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL-I EES PAI 9420 OLIVEDST SS:
ON FILE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803156
ASSESSOR IN OR T O NUMBER: NEAREST CROSS STREET: ENCINITA
8590-003-017 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 SS ED ON: PROCESSED : PL Y: EXPIRES ON:
30 AIR INLETS/OUTLETS 6.00 UNI 26.10 05/04/00 UT 10/31/00
TOTAL FEES 107.85
OWNER: TEL. N0: FINAL DATE FINAL BY: �E:
HATLEY FAYE J (626) 287-9307- 'If �d
9420 OLIVE ST
TEMP 917803156 DESCRIPT 0 OF OR
INSTALL NEW HVAC SYSTEM
APPLICANT: TEL. NO:
CYPRESS HEATING AND AIR COND. -
547 S. LORAINE AVE SPECIAL CONDITIONS:
GLENDORA, CA
CONTRACTOR: TEL. N0:
CYPRESS HEATING AND AIR CONDITIONIN (626) 963-9810- L+� APPROVALS DATE INSPECTOR SIGNATURE
547 P'
GLENDORA,NE AVE LIC. NOCA. 91741 593268 C20 * ���?� v�� FA /WAL UR ACE
COMBUSTION AIR OP
!- \
ARCHITEC 0 ENGINEER: TEL. N0: - �� y[ �\ � DUCT WORK
LIC. NO:�/ -j AC/COMPRESSOR
_• __-__ I y,l THERMOSTAT
JI_
FIRE DAMPERS
TD: J I�) C 1�n1 UULD)C � SMOKE DETECTION DEVICES
COMMERCIAL HOOD
�qT.
F
a st 3 Service
* ADDITIONAL DATA ON FILE
REPORT ID: DPR264 ROUTE TO: BS0508
ION
WORKER'S have
aceSATate of consent to 76A348DPW9/89 APPLICATION FOR PERMIT LIME GREEN
76A3(I4C
I hersby attirF;l ghat I have a certificate of consent to self insure,
or a certificate o6..Worker's Compensation Insurance,or a certified HEATING-VENTILATING-AIR CONDITIONING
copy thereof(Sec.3800 Lab.C.)
Policy No. Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
❑ Certified copy Is hereby furnished.
F1Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING �. ex,I�� �
department. (PRINT OR TYPE ONLY) ADDRESS
Date Applicant NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST CROSS ST. i`/Y` �LL"D cak"6 S' -
ABSORPTION UNIT,BTU ASSESSOR COMPENSATION INSURANCE �3
(This section need not be completed If the work Involved by the MAP BOOK BMJ–I Q PAGEW:j PARCEL O/ �f
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person In any manner so as to BOILER,BTU J
become subject to the Workers'Compensation Laws. jJ
COMPRESSOR,BTU
Date � -12 Applicant S VENTILATION SYSTEM APPROVALS DATE INSPECTOR'S SIGNATURE
10
NOTICt TOAPPLICANT: If, after making this Certificate of ROUGH —Zy
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code, you must forthwith comply with such FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED—UNIT—
(commencing
USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business and HEATER: WALL Z_9q14'd00)31X;7
Professions Code,and my license is in full force and effect.
License Number Lic.Class _
13
Contractor Date
El Plan check fee I am exempt under Sec. C
B.&P.C.for this reason PERMIT ISSUING FEE$ e-1 rdo
s 1-
Date: TOTAL FEE ., p G
Signature U
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
G
1 hereby affirm that I am exempt from the Contractor's License Law NAME ;5fw % 745
for the following reason(Section 7031.5, Business and Professions
Code): ADDRESS
❑ I, as owner of the property, or my employees with wages ?�� G�A2�E7 •
as their sole compensation, will do the work and the CITY P..�1�� A TEL.NO. Ss$�
structure is not Intended or offered for sale(Section 7044,
Business and Professions Code). OWNER
❑ I, as owner of the property, am exclusively contracting MAIL
with licensed contractors to construct the project (Sec- ADDRESS g CLj JE
tion 7044,Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITY TRZ TEL.NO. g3�
I hereby affirm that there is a construction lending agency for CONTRACTOR
the performance of the work for which this permit Is issued �yL 'ryl(fpl>� j
(Sec.3097,Civ.C.).
ADDRESS.1-4eq " A"ar -..4,
Lender's Name � �7�! -
CITY G � p TEL.NO. Q 1zU
Lender's Address `
I certify that I have read this application and state that the above LICENSE NO. Sj 3 CLCASS
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 the above-mentioned
pro rty for 1 paction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
hZ
SIGNATURE OF APPLICANT OR AGENT 0 TE