HomeMy Public PortalAbout9517 OLIVE ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0909150005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS:
ON FILE I I 9517 OLIVE ST I
]FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803132 1
]ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: CLOVERLY ]
18588-025-020 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl
102 COMPRSR < 100 KBTU 1.00 COM 27.00 1 I
ITENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I
I 130 AIR INLETS/OUTLETS 9.00 UNI 39.15 109/15/09 SR 09/15/10 1
I 1 TOTAL FEES 120.90 1 ]
1OWNER: TEL. NO: I Iq"7fl FI AL Y: CODE:
IGAVREL JAMES T (323) 283-3400-
19517 OLIVE ST 1 I I
TEMP 917803132 1 1DE CRIPTI N OF WORK I
I I (INSTALL CENTRAL HTG & AIR 1
APPLICANT: TEL. NO: 1 I I
AMERICAN HTG & AIR (626) 285-8206- 1 I 1
15308 NOEL DRIVE I ISPECIAL CONDITIONS: I
ITEMPLE CITY CA 91780 1 1
I I I I
CONTRACTOR: TEL. NO: 1APPROVALS DATE INSPECTOR SIGNATURE 1
AMERICAN HEATING AND A, C (626) 285-8206-
I5308 NOEL DR. LIC. NO 1 1FAU/WALL FURNACE
TEMPLE CITY, CA 91780 664929C20 1 I
(COMBUSTION AIR OPENINGS 1
ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I I I
LIC. NO: 1 IAC/COMPRESSOR �� �
II I
ITHERMOSTAT
I I I
IFIRE DAMPERS 1 I I
I I I
I (SMOKE DETECTION DEVICES
I I ICOMMERCIAL HOOD 1 1 1
] 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 I I I I
I I I I I I
• I; t, g� n
WORKERS'COMPENSATION DECLARATION CE�b._ ,1-801 6 LLQ��H�D®u ®� ��
I hereby affirm that I have a• certificate of cdts-4yt-tq Telf ;
insure, or a certificate of Workers'Compensation Insurance,or � HEATING-VENTILATING-AIR CONDITIONING
a certified copy thereof(Sec. 3800,Lab.C.)
Policy No. Company
Certified copy is hereby furnished. I COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy is filed with the county building inspection BUILDING +,J
department. FOR APPLICANT TO FILL IN
Date Applicant (PRINT OR TYPE ONLY) ADDRESS.
LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPENSATION INSURANCE NEAREST
(This section need not be completed if the work involved ABSORPTION UNIT, BT I CROSS ST. d
by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. P ESSE BY U
+
1 certify that in the performance of the work for which this AIR HANDLING UNIT,CFM f/
permit is issued, I shall not.employ any person in any manner �a 6!/) `-' cc
so as to become subject to the Workers'Compensation ws. BOILER.,BTU t? Q
/ �� APPROVALS DATE INSPECTOR'S SIGNATURE V
Data tn-JApplicant COMPRESSOR,BTU ROUGH a
NOTICE TO APPLICANT: If, yer making this Certificate of VENTILATION SYSTEMFINAL �'�- Z
Exemption, you should become subject to -the Workers'
Compensation provisions of the Labor Code, you must forth-. EVAPORATIVE COOLER VALIDATION
with comply with such provisions or this permit shall be
deemed revoked.
FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION " FLOOR: BTU
I hereby affirm that I am licensed under provisions of Chapter HEATER: SUSPENDED UNIT
9 (commencing with Section'7000)of Division 3 of the Busi- WALL
ness and Professions Code, and my license is in full force and
effect.
License Number Lic.Class
Contractor Date
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer Plan check fee 25%of above.
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code). 1 PERMIT ISSUING FEE$ C
Lic,or Reg.No.. Date TOTAL FEE 3 .�
HOME OWNER=BUILDER DECLARATION PLAN CHECK APPLICANT
oz 6
I hereby affirm that I ant exempt from- the Contractor's NAME
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code): + ADDRESS
MI, as owner of the property, will do the work and the
structure is not intended or offered for sale (Section + CITY ,_,4E;. NO. 4 2'2.•9 R
7044,Business and Professions Code).
I, as owner of the property, am exclusively contracting f OWNER r + f 0,0 010 0
with licensed contractors to construct the project I MAIL > 2 e o 4 3 O
(Section 7044, Business and Professions Code). ADDRESS f
CONSTRUCTION LENDING AGENCY CIT �. T o,e o lG J 0,
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is ' CONTRACTOR,-`*'
0603,-82
issued (Sec. 3097,Civ.C.).
Lender's Name ' ADDRESS
Lender's Address CITY TEL.NO.
+ I certify that I have read this application and state that the STATE LIC.
above information is correct.I agree to comply with all County LICENSE NO. CLASS
ordinances and State laws regulating Heating, Ventilating and
Air Conditioning,and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to eater upon the above-mentioned property for
inspection.purpos
Sign U
ure of Permittee Date