HomeMy Public PortalAbout5703 PRIMROSE AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0901140007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: [
ITR: 6561 IT: 657 BL: .001 I I 15703 PRIMROSE AV
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917802508 I
(ASSESSOR INFORMATION NUMBER: 11 I NEAREST CROSS STREET:
18587-011-002 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
1 102 COMPRSR < 100 KBTU 1.00 COM 27.00
[TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 IISSUBD ON: PROCESSED BY: PLAN BY: EXPIRES ON: [
[ TOTAL FEES 81.75 101/14/09 SR 07/13/09
(OWNER: TEL. NO: IFINAL D 8 FI Y: CODE: [
1WENNBO (626) 287-1203- I I D
157035703 PRIMROSE AV
ITEMP 917802508 [ IDESCRIPT ON OF WORK I
ICHANGE OUT AIR CONDITIONG AND HEATING SYSTEM I
I I I I
(APPLICANT: TEL. NO: I I I
ICARRA CONTRERAS OF CONNOR AIR (626) 286-3157- I I I
14931 ENCINITA AVE. I ISPECIAL CONDITIONS: I
ITEMPLE CITY CA 91780 I
ICONTRACTOR: TEL. NO: I JAPPROVATS DATE INSPECTOR SIGNATURE I
[CONNOR AIR CONDITIONING (626) 286-3157- 1 1 I
14931 ENCINITA AVE LIC. NO I JFAU/WALL FURNACE I I I
TEMPLE CITY, CA 91780 403735 C2O I I I [ I
ICOMBUSTION AIR OPENINGS I [ I
(ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I I I
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LIC. N0: i iAC/COMPRES3OR i //� I
d I THERIMSTAT I
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I I [FIRE DAMPERS
I ISMOKE DETECTION DEVICES I I I
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I I (COMMERCIAL HOOD I I [
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IREPORT ID: DPR264 ROUTE TO: BS0508 I I I I
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WORKERS'COMPENSATION DECLARATION I 7EA$6 e �z-Bo, A P P L IC A T I O N i FO R PERMIT
I hereby affirm that I have a' certificate of consent to self ]
insure,or a certificate of Workers'Compensation Insurance,or i HEATING-VENTILATING-AIR CONDITIONING
a certified copy thereof(Sec.3800,Lab.C.)
Policy NR ?1any Fremont Tnd 'mni ty' COUNTY OF LOS ANG LE •LQ�SAFETY
Certified copy is hereby furnished. /` �/
I !P
'
e;e® Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN UI LDING
department. ADDRESS 5703 N. Primrose
Date Applicant (PRINT OR TYPE ONLY)
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY - Temple Cit
COMPENSATION INSURANCE CROSS ST. a
(This section need not be completed if the work involved ABSORPTION UNIT,BTU CL
I the permit is for one hundred dollars k for or less.)
is DISTRICT N� PR BY
OU
I certify that in the performance of the work for will h this AIR HANDLING UNIT,CFM.
permit is issued, I shall not em any person in an anner j(? f
so,as to beco subject.to the kers'Compensa Laws. BOILER,BTUH
- APPROVALS DATE PECTOR s GNATURE W
Date v 'J Applicant COMPRESSOR,BTU — N
ROUGH
NOTIC TO APPLICANT: If, after making this Certifi a of I VENTILATION SYSTEM
Exemption,'you should become subject-to the Workers' FINAL
Compensation provisions. of the Labor Code, you must forth- EVAPORATIVE COOLER Al '6
,6 � VALIDATION
with comply with such provisions or this permit shall be
deemed revoked. 1 FURNACE: FAU X GRAVITY - 1
LICENSED CONTRACTORS DECLARATION FLOOR: BTU
I hereby affirm that I am licensed under provisions of Chapter i HEATER: SUSPENDED UNIT
9 (commencing with Section 7000)of Division 3 of the Busi- I WALL
ness and Professions Code, and my license is in full force and
effect. 221751 C-20 �.
License W. r Lic.•Cla y
Contra E S I
I am exempt from the .arising requirements as I am a
licensed architect or a registered 'professional'engineer I Plan check fee 25%of above. 62-0
acting-in my professional capacity (Section 7051, Bus-
iness and Professions Code). PERMIT ISSUING fEE$
Lic.or Reg.No. Date I 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 1
structure is not intended or offered for sale (Section CITY TEL.NO. `• 6 1'P
7044,Business and Professions Code).
OWNEREarl Bruce {. 1- ° ° '
I, as owner of the property, am exclusively contracting '
with licensed contractors to construct the project MAIL
(Section 7044,Business and Professions Code). ADDRESS 0 ..0 n - 2
CONSTRUCTION LENDING AGENCY CITY TEL.NO. C ° ° C l (i L�
I hereby affirm that there. is a construction lending agency n J
for the performance of the work CONTRALTO
for which this permit is RBr .ant Heat. & A. C. I
issuedrSec.3097,Civ.C.).
LenderSsName ADDRESS 135 r
I t {
Lender's Address •'LSTATE
TY TEL.NO. ,
I certifythat I have read this application and state that the
Pp i • LIC.above information is correct.I agree to comply with all County CENSE NO. 221751 jQ2 0:
ordi nces and State laws regulating Heating, Ventilating and ;
C nd;tioning,andh by authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
ou y to enter up the above- entioned properly for
tion purpos I'
Signatureof Permittee Date _