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Home My Public Portal About6118 PRIMROSE AVE_Mechanical__ GA3G4—Otata—I-GG APPLICATION. FOR PERMIT HEATING - VENTILATING - AIR CONDITIONING COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FADDR G t"J qt �.. JOHN A. LAMBIE, COUNTY ENGINEER S ,l.h COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGTY i FOR APPLICANT TO FILL IN NEAREST T. f(Print or type only) ,.. y-No.. TYPE,OFAPPLIANCE OR EQUIPMENT FEESU j•I7ABSORPTION SYSTEM, BTU 71 + TEL. NO.�7 AIR HANDLING UNIT, CFM CONTRACTOR ., i' : *` BOILER, HORSEPOWER 7 —0 ADDRESS 7 ` COMPRESSOR, HORSEPOWER _ ++T� CITY �� / rV'!1'- TEL. NO. -1=�f STATE LIC. VENTILATION SYSTEM LICENSE NO. `� L�� CLASS EVAPORATIVE COOLER DISTRICT NO. GROUP ZONE RO SSED BY FURNACE: FAU GRAVITY off- FLOOR—BTU /I INSPECTION RECORD C) V HEATER: SUSPENDED—UNIT a WALL p - v CAIw D_ • Z NEW—ADDITION— PERMIT $ ALTER—REPAIR— TOTAL FEE $ 19WQ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY LI ALL COUNTY ORDINANCES AND STATE LAWS REGULATING G, VVTILATINO, AIR CONDITIONING. EREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION PTER 9, DIVISION 3, OF 5'HE BUSINESS AND PROFESSIONALF THE STATE�OF-&LLIFO NI APPROVALS DATE INSPECTOR'S SIGNATURE TURE r (/l i F/41 J /�1� ROUGH RMITTEE l VVl �r �" �" ' FINAL � �� •,, VA I ATION JACK R. ALLEN CK. O. CASH SUPERVISING MECHANICAL ENG'R. o 4 441 1 9.5 0 ,6-" IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ARKER'S COMPENSATION DECLARATION 76A364�PW 9/a9 APPU ATIO p FOR PERS,/ T �� ,�i I hereby affirm that I have a certificate of consent to self Insure, �g �I �1�� EG JJO� or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING copy thereof(Sec.3800 Lab.C.) Policy No.G961113001.company Cal Comp COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. ® Certified copy is hereby furnished. Certified copy is filed with �tybullding inspect'e FOR APPLICANT TO FILL IN BUILDING department. (PRINT COR TYPE ONLY) ADDRESS 6118 N. Primrose Ave. Date 5/8/96 Applican NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Temple C i t CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE ABSORPTION UNIT,BTU CROSS ASSESSOR Garibaldi (This section need not be completed if the work Involved by the MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or'less.) I AIR HANDLING UNIT,CFM DISTRICT NO. PROCESSED BY I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to BOILER,BTU G �yL become subject to the Workers'Compensation Laws. COMPRESSOR,BTU `7i1 y d a t7 lv d APPROVALS DATE INSPECTOR' NATURE Date Applicant VENTILATION SYSTEM / NOTICE TO APPLICANT: If, after making this Certificate of ROUGH Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER provisions of the Labor Code,you must forthwith comply with such FINAL �7 provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY / p VALIbATI®N LICENSED CONTRACTORS DECLARATION FLOOR BTU �O (� I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED-UNIT- (commencing USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business and WALL Professions Code,and my license is in full force and effect. Re lacement of Existing License Number 221751 Lic.Class C-20 Heat/Cool Unit Ia Contractor to 5/8/96 C CJ Plan check fee I am exempt under Sec. Qa B.&P.C.for this reason PERMIT ISSUING FEE$ 27 30 C Date: TOTAL FEE LL Signature 8 Cr OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT ACCTobT 1 hereby affirm that I am exempt from the Contractor's License Law NAME w ? -� n for the following reason(Section 7031.5, Business and Professions 3303 80050 Code): ADDRESS 1 ITEMS 1, as owner of the property, or my employees with wages as their sole compensation, will do the work and the CITY TEL.NO. TOTAL 80 o-°-0 structure is not intended or offered for sale(Section 7044, CHECK n n • CHEC Business and Professions Code). OWNER V K 80.50 I, as owner of the property, am exclusively contracting MAIL CHANGE .00 with licensed contractors to construct the project (Sec- ADDRESS 6118 N. Primrose Ave. tion 7044,Business and Professions Code). CITY Temple City TEL.NO. 287-1611 CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for 10000-0001 1 .t:f [i! �} � 54 the performance of the work for which this permit Is issued CONTRACTOR Bryant Heating & A/C, Inc. D � 0� i �10e (Sec.3097,Civ.C.). Lender's Name ADDRESS 1350 E. Las Tunas Drive CITY San Gabriel TEL.NO. 286-1141 Lender's Address STATE C. I certify that I have read this application and state that the above LICENSE NO. 221751 CLASS C-20 information is correct. I agree to comply with all County ordinances and State laws relating to building construction,and hereby authorize resentatives of this County to enter upon the above-mentioned A,INP.T forinspection pur ea. SEE REVERSE FOR EXPLANATORY LANGUAGE ��9- A A T OR ENT DATE