HomeMy Public PortalAbout9919 OLIVE ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9706120001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING SS:
ON FILE 9919 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803239
ASSESSOR INFOR14ATION NUM R: NEAREST CROSS STREET: BALDWIN
8588-019-012 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 2.00 COM 54.00
TENANT: 08 FURNACE/HEATER <100 2.00 UNI 54.00 ISSUED ON: PROCESSED BY: PAN BY: EXPIRES
30 AIR INLETS/OUTLETS 17.00 UNI 73.95 06/12/97 TC 06/12/98
TOTAL FEES 209.70
OWNER: TEL. N0: FINAL DATE FINAL BY CODE:
NEWMAN ROBERT E;RENEE M (818) 285-2602-
9919 OLIVE ST
TEMP 917803239 DESCRIP 0x Or MUKK
2 HEATING AND A/C UNITS FOR NEW S
PP O:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
• SAME AS OWNER -
LIC. NO A FURNACE
COMBUSTION AIR OPENINGS Z
ARCHITECTOR ENGINEER: TEL. NO: DUCT ,WORK
LIC. NO: - AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKEDETECTION DEVICES
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508
.WUR KILRS'COAtYFiNSATION DECLARATION CEA 801 B (2-80) A P P L IC A T�®N FOR P E R T
I hereby affirm that I have if certificate of consent to self
insure, or a certificate of Workers'Compensation Insurance,or HEATING-VENTILATING-AIR CONDITIONING
a certified copy thereof(Sec.3800,Lab.C.)
Policy No. Company
BUILDING
E] Certified copy is hereby furnished. COUNTY OF LOS ANBUILDING AND SAFETY
❑ Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING
department. ADDRESS
Date Applicant (PRINT OR TYPE ONLY)
LOCALITY r
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
COMPENSATION INSURANCE NEARESTCROSS ST. ��-( ^ A.) CL
(This section need not be completed if the work involved ABSORPTION UNIT, BTU p
by the permit is for one hundred dollars ($100) or less.) --- DISTRICT NO. PR ED U
I certify that in the performance of the work for which this AIR HANDO
LING UNIT,CFM Qcc
permit is issued, I shall not employ any person in any manner d
so as to become subject to the Workers'Compensation Laws. BOILER,BTUl
I APPROVALS DATE INSPECTOR'S SI TURE L 3
Date Applicant COMPRESSOR,BTU ROUGH - -.J N
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL t 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: S NDED N T O eg
9 (commencing with Section 7000)of Division 3 of the Busi-
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).
Lic.or Reg.No. Date TOTAL FEE
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that 1 am exempt from- the Contractor's NAME
G C[.�+pl+ -r
ILicense Law for the following reason (Section 7031.5, Busi-
ess and Professions Code): ADDRESS
I, as owner of the property, will do the work and the CITY TEL.NO.
structure is not intended or offered for sale (Section
7044, Business and Professions Code). 0496 '1,
❑ OWNER r1 f- 10
��jl� Ek
I, as owner of the property, am exclusively contracting f`—
with licensed contractors to construct tate project MAIL C) 0 0 0 .o o
(Section 7044,Business and Professions Code). U,SaZ.)
�� ✓
CONSTRUCTION LENDING AGENCY TEL.NO.LO t o o ' 7.00-
C
Q.
I hereby affirm that there is a construction lending agencyo c ' f c,ifor the performance of the work for which this permit is issued Sec.3097,Civ.C.). ,Lender s Name Lender's Address � TEL.NO. 29 g -371.
I certify that I have read this application and state that the STATE if 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 SEF.REVERSE FOR EXPLANATORY LANGUAGE
County to nter Pon the above-mentioned property for
' f illsU;1
"Po.
Sig atu a of Permittee Date i