HomeMy Public PortalAbout6037 PRIMROSE AVE_Mechanical__ rr COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1203060002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
[LEGAL ID: FEES PAID 1 BUILDING ADDRESS:
[
ITR: 44381 LT: 1 UN: D 6037 PRIMROSE AV iI
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917802006
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: I
15385-007-034 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
102 COMPRSR < 100 XBTU 1.00 COM 27.00
ITENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN BY:
I �30 AIR INLETS/OUTLETS 6.00 UNI 26.40 03/06/12 SR
TOTAL FEES 108.20
(OWNER: TEL. NO: I F TS FI CODE:
IFUNG KAI TAK;STELLA W (626) 823-7505- [ I
16037 PRIMROSE AV [ , I I
ITEMP 917802006 DESCRIOTION OF WORK [
I (REPLACE AC 3.5 TON REPLACE FURNACE BTU 80,000 I
(APPLICANT: TEL. NO: 1
DOMINGUEZ, ROY (714) 901-0500-
11330 KNOTT ST. [ [SPECIAL CONDITIONS:
GARDEN GROVE 92841
I
(CONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1
IAPLUS HEATING AND A, C (714) 901-0500-
1I 1
1330 KNOTT ST LIC. NO [ IFAU/WALL FURNACE I [ I
GARDEN GROVE CA 92841 763154-C20
I i (COMBUSTION AIR OPENINGS I I I
(ARCHITECT OR ENGINEER: TEL. NO: I [DUCT WORK [ I I
LIC. NO: [ 1AC/COMPRESSOR 1 I [
1 I THERMOSTAT
FIRE DAMPERS I 1 I
I I I I I I
I I (SMOKE DETECTION DEVICES I I I
1 i iCOMMERCIAL HOOD
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1 [REPORT I33:,DPR264 ROUTE TO: ',BS0508 1 [
I I
TION
WORKERS' I have a cerci DECLARATION APPLICATION FOR PERMIT
'1 hereby affirrtl that I Have a certificate of consent to self ,
.,,insure, dr a certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING
or a certifie1d copy thereof(Sec. 3800, Lab. C.)) I 76A364C
P Icy NoWD ��/companyeHaAl7 /N)PCftr CE-818(REV. 10/81)
Certi ied copy is hereby furnished. y COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING ?,
tion department. (PRINT OR TYPE ONLY) ADDRESS c/
Date —2 oQApplicant LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM S' NEAREST
COMPENSATION INSURANCE CROSS ST.
(This section need not be completed if the work involved by ABSORPTION UNIT,BTU DISTRICT NO. PROCESSED
the permit Is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM �'
I certify that in the performance of the work Tor which this ✓` ��
permit is issued, I shall not employ any person in any manner BOILERBTU
so as to become subject to the Workers'Compensation Laws. , V/� APPROVALS DATE ECTO ' GNATU
Date Applicant COMPRESSOR,BTU ��� ROUGH
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER IALIDATI N
with comply with such provisions or this permit shall be
deemed revoked. / FURNACE: FAU VITY
LICENSED CONTRACTORS,DECLARATION r FLOOR BTU
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED—' UNIT
'(commencing with Section 7000)of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect. IL
�- Gs X02'0 "° 2 O
License Number Lic. Class oil. V
IIX
Contractor r to
❑ I am exempt un
Plan check fee
B.BP.C. for this reason'
Date: PERMIT ISSUING FEE$ S
Signature TOTAL FEE
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT 2 7 1 3,2.A
I hereby affirm that I am exempt from the Contractor's License , # 0 0 0 0 0 8
Law for the following reason (Section 7031.5, Business and NAME
Professions Code): I o,o 4 2 7 5
❑ I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and o.o'0 42755
the structure is not intended or offered for sale(Section CITY TEL. NO.
7044, Business and Professions Code). OWNER FRIW (< Ts,0ZC 0528-87
❑ I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec- MAIL ADDRESS .6. IN�ryFS W��
tion 7044., Business and Professions Code). IS
CONSTRUCTION LENDING AGENCY CITY LE e/z TEL. NO.
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued CONTRACTOR �� /'76 _ at,0.�71I Af IA(
(Sec. 3097, Civ. C.).
ADDRESS
Lender's Name
CITY�y¢� r'g�lJ['p TEL. NO.�'iV4 72-0 -fdo-
Lender's Address
•yF R �i
STATE ICEN S. LIC, p a a
I certify that I have read this application and state that the LICENSE NO. �os�s CLASS. C..
above information is correct. 1 agree to comply with all County
ordinances and State laws relating to building construction,
and hereby authorize representatives of this County to enter
upon the a v -mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
— 2- 7
Signature o lic t or Agent Date -