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Home My Public Portal About9430 PENTLAND ST_Mechanical__ 6A364-- CEBIB - 3-69 . APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS L BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER LOCALITY Cl l.OLEMAN W JENKINS SUPERINTENDENT OF BU`LDING NEAREST CROSS ST FOR APPLICANT TO FILL IN OWNER (PRINT OR TYPE ONLY) MAIL NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADOR ESS ABSORPTION SYSTEM BTU CITY TEL NO CONTRACTOR AIR HANDLING UNIT CFM ADDRESS BOILER HORSEPOWER CITY TEL NO VOY� COMPRESSOR HORSEPOWER STATE LIC LICENSE NO CLAS VENTILATION SYSTEM DISTRICT NO GROUP ZONE /PFp(E SSEO BY EVAPORATIVE COOLER FURNACE FAU GRAVITY J ' FLOOR BTU INSPECTION RECORD HEATER_SUSPENDED-UNIT- WALL UNIT_WALL a O V s O V w D_ an NEW_ADDITION_ PERMIT S 3 00 Z ALTER—REPAIR— TOTAL FEE S PLAN CHECK APPLICANT NAME ADDRESS I' J CIT IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.COMPLY WITH ALL ORDINANCES,AND LAWS REGULATING HEATING VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE LATING AIR CONDITIONING I HE CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH CHAPTER 9 VISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL CODE OF THE E OF IFORNIA _ J SIGNATURE - � JACK R ALLEN, SUPERVI ECHAHICAL EHG'R OF PERMI EE ' PERMIT VALIDATION CK M 0 CASH PLAN CHECK VA ATION 4 3 1" JUL 14 4 1 D 1 0.0 0 'EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 7G 3^ 149- 098198-9/75 , 4 APPLICATION FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING ' I I • BUILDING D SAFETY DI ION FOR APPLICANT TO FILL IN BUILDING �- (PRINT OR TYPE ONLY) ADDRESS 94 and LOCALITY Temple Ci ' NO TYPEOFAPPLIANCEOR EQUIPMENT FEE NEAREST , CROSS ST ABSORPTION UNIT BTU ' OWNER Dan M o AIR HANDLING UNIT, CFM MAIL ADDRESS 9430 Pentland BOILER, BTU ' CITY Temple 01ty TEL NO 285-7081 COMPRESSOR, BTU CONTRACTOR Bryant Heat. & Air Cond. Inc. VENTILATION SYSTEM ADDRESS1350 E. Las Tunas Drive EVAPORATIVE COOLER CITY San Gabriel TEL ,NO 286-1141 x FURNACE FAU_GRAVITY STATE LIC FLOOR BTU LICENSE NO 221751 ~ CLASS 020 1 HEATER SU SPENDGQ.�,-_UNIT_ 7 50 olsTnlci No oxouP xONE PR Es9Eo a WALL JlJ 1V1 DLll _ r S 1 c~J INSPECTION RECORD CIL. Plan check fee 25%O of above �— PERMIT ISSUING FEE S 4 50 TOTAL FEE NI 12100 PLAN CHECK APPLICANT J NAME ADDRESS CITY TEL NO `- HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 1 STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY AND WITH ALL ORDINANCES AND LAWS REGULATING HEATING VLNTI LATIN AIR CONDITIONI 0 I HEREBY CERT T THAT AM NOT ACTING VIOLATION APPROVALS DAT 9919MAiVlIL OF CHAPTER 9 OIVI } 3 OF THE BUSINESS AND OFE9SIO NAL CODE OF THE STATE F ALIFORNIA ROUGH SIGNATURE OF PERMITT FINAL PLAN CHECK VALIDATION CK M o cnsX PERMIT ALIDATION M o CASH 0,6:0'-NDV` 1 4 1 0 1 2,0 0 •� -� — - rp✓G) WORKER S COMPENSATION DECLARATION t 2043643 W9rBs, APPLICATION FOR PERMIT LIME GREEN, C� I horeby'eff f. that I have a certificate of consent to self insure ]sA364C ' or a certificate of Worker a Compensation Insurance oy�certified � a. y_~ HEATING- VENTILATING - AIR CONDITIONING, copy thereof(Sec 3800 Lab C) Lr•JL!-0 0m250168470 G;mpany WeSt Americ COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV fled copy m hereby fumishad • ' ' BUILDING_ - ti Certified copy is filed wr the county bulldnlg inspection FOR APPLICANT TO FILL IN ADDRESS r de ant +' I (PRINT OR TYPE ONLY) 9430 Pentland 1 I Date /9m (c_,applman '4 LOCALITY. le City , Tri NO TYPE OF APPLIANCE OR EQUIPMENT •FEE + CERTIFICATE OF EXEMPTIO OM W KERS w . NEAREST S t COMPENSATION INSURANCE CROSS ST le Cit Blvd.- ABSORPTION UNIT BTU ASSESSOR ` (This section need not be completed If the work Involved by,`he - * MAP BOOK PAGE PARCEL, ,� permit Is for one hundred dollars($100)or lose) , AIR HANDLING UNIT CFM systax:r ra Pp'CEa6Ea er • ` I certify that in the performance of the work for which this permit _ Y Is Issued I shall not employ any person in any manner ea as to BOILER BTU become subject to the Workers Compensation Laws ' • COMPRESSOR BTU 8� a ' MPnWALe' oATE sslcaArvP,= / Date - Applicant s VENTILATION SYSTEM r NOTICE TO'APPLICANT If,after making this Certificate of ` _ _ ROUGH Y Z- Exemption you should become ubject to the Workers Compensation EVAPORATIVE COOLER provisions of the Labor Code you must forthmth comply with such FINAL _ provisions or this permit shall be deemed revoked FURNACE I FAU GRAVRV - 6 ,VALIDATION + ae' r t LICENSED CONTRACTORS DECLARATION ' FLOOR - ' BTU J , I hereby affirm that I am licensed under provisions of Chapter 9HEATER + SUSPENDED •UNIT_ (commencing with Section 7000)of Dlvmlon 3 of the Business and - WALL - r Professions Code and my license Is in full force and effect ' + U ou O r t License Number- F41 1 Fit LIc Class C-90 CclatrM Date O Plan check fee em exempunder Sec B BP C for th s reason PERMIT ISSUING FEES oma TOTAL FEE: 3 p , W ' _ I a x Signature - PLAN CHECK APPLICANT y OWNER BUILDER DECLARATION A u - s _ Z hereby affirm that I am exempt from the Contractors License Law NAME ° +' r - t ^ 4x r ` • + t ' ior'ths following reason (Section 7031 S Business ands Profenions I. " ' r Code) 12 ADDRESS ❑V ADDRESS I+es owner of the property or my employees with h wages e i �+�+ t C Iar es their sole compensation will do,the work and the CITY . I,TEL NO structure Is not Intended or offered for sale (Section 7046 ` , OWNER, r 'T Business end Professions Code) ' Dan & Sue gone _,iEItS I as owner of the property am exclusively contracting MAIL tt wnh licensed contractors to construct the project (Sec ADDRESS 9430 Pentland. a 1CiAL z 1 .13 . 38 hon 7044 Business and Professions Code) ' — -, CONSTRUCTION LENDING AGENCY Cf7Y le City, Ca.`.r TEL yO _ , CHECKP3, I hereby affirm that there Is a construction lending agency for the perto r mance of the work for which this permit Pe Issued CONTRACTOR _ (Seo 3097 Civ C) — ' - .. • _ _ 'tO l• a. ADDRESS 1122 Dr Lender s Name _v __ 1- crry T1 73- Arcadia - TEL PO 446-8844' -y-Lapeer a Redress STATE 541161 UC C-20 "=`T' =-'-H�< - •� I certify that I have reed this application and stale that the above LICENSE NO CLASS , Information Is correct I agree to comply with all County ordinances ' and State laws relating to building construction end hereby authorize representatives of this County to enter upon the above mentioned _ " _ propertr Ins" ion purposes SFE REVERSE FOR EXPLANATORY LANGUAGE - - 1 . '• - e r'+ i Cello-, d7 ddn NA ORE FA P ADEM 1 ' , , • e , r ,4' q 1 t