HomeMy Public PortalAbout9239 PENTLAND ST_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 v MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0010250008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 12210 LT 7 9239 PENTLAND ST
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803736
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET CLOVERLY
8590-009-025 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY
O8 FURNACE/HEATER <100 1 00 UNI 27 00
TENANT TOTAL FEES 54 75
ISSUED ON PROCESSED BY PLAN BY EVFrWFFbW--
10/25/00 UT 04/24/01
OWNER --T-EL--WO- FINAL DATEBYCODE
CAI JEFFREY -
9239 PENTLAND ST
TEMP 917803736
7'91PIIUN OF WORK
WALL HEATER FOR GUEST HOUSE
llp�LIUANI TEL NO
WILD E'S CONSTRUCTION (626) 448-2175- l
4905 BALDWIN SPECIAL CONDITIONS
TEMPLE CITY, CA
CONTRACTOR Pn1GELES CO
TEL NO SGS APPROVALS E INSPECTOR SIGNATURE
WILDE'S CONSTRUCTION (818) 448-2175-
4905 BALDWIN AVE LIC NOFAU/WALL FURNACE
TEMPLE CITY CA 91780 401407 B
/ COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER
it DUCT WORK
LIC NO/ 1111111 A
THERMOSTAT
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FIR DAMPERS
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" ADDITIONAL DATA ON FILE
REPORT ID DPR264 ROUTE TO RS0508
WORKERS'COMPENSATION DECLARATION consent
CeA ;$(2-80) Q p p�p CO Q T( O N FOR FCR (evil 0 lT'
I hereby affirm that I have a' certificate of consent to self
insure, or a certificate of Workers'Com—nsation Insurance,or HEAT11(NG_VENTOLATING-AlM COG`S'DOTO®N oNG
Certified copy is hereby furnished.
COUNTY OF LOS ANGELl�3_�!��� RUILD11NG AND SAFETY
�- �
Certified copy is filed with the county building inspection
department. FOR APPLICANT TO FILL IN BUILDING
Date Applicant (PRINT OR TYPE ONLY) ADDRESS
LOCALITY.
CERTIFICATE OF'EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEEL
COMPENSATION INSURANCE NEAREST }
(This section need not be completed if the work involved, ABSORPTION UNIT, BTU CROSS ST. �� r jf� CL
by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. PROC ;`2D BY U
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFd
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws. BOILER,
/ BTU APPROVALS DATE TINSPECTOR'S S—
ATURE W
llate Applicant COMPRESSOR, V
ROUGH a
Cn
NOTICE TO APPLICANT: If, after making this Certificate of
VENTILATION SYSTEM FINAL S �� --� z
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER
with comply with such provisions or this permit shall be VALIDATION
deemed revoked. FURNACE:. FAU_A�— G ITY
LICENSED CONTRACTORS DECLARATION FLOOR: BTU_ , /a. erLe x
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 pm 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). PERMIT ISSUING FEE $ 71 11 '0
Lic,or Reg.No. Date TOTAL FEE
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from- the Contractor's NAME
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code): ADDRESS
I, as owner of the property, will do the work and the
structure is not intended or offered for saleSection CITY TEL. NO.
( 2409,5A.
7044, Business and Professions Code).
J
I, as owner of the property, am OWNER #'0'0101'0.4 1 exclusively contracting
with licensed contractors to construct the project MAIL /
(Section 7044, Business and Professions Code). ADDRESS _2 / �_��+r�TQ�CJ 2.°.° 2 7,0 0
CONSTRUCTION LENDING AGENCY CITY +� I TEL.NO:��� / Z .0'0'0 2 7.0 0 5
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is CONTRACTORil��J f nq19y� /7 0 21 '8—8 1
issued(Sec. 3097,Civ..C.).
Lender's Name ADDRESS
Lender's Address CITY TE'L. NO.
z.z__I23
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. _�
ordinances and State laws regulating Heating, Ventilating and
Air Conditioning, and hereby authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
County to enter upon the above-mentioned property for
ns ection purposes.
Signature of Permittee Date