HomeMy Public PortalAbout6330 PRIMROSE AVE_Mechanical__ 76A364 - CE848 - 3-69 • -
APPLICATION FOR PERMIT
` HEATING - VENTILATING - AIR CONDITIONING
OF LOS LES BUILDING
DEPT ROTMENT UNTY OF COUNTY ENGINEER ADDRESS 6330 North Primrose
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY Temple Cit
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER Walter Stran man
(PRINT OR TYPE ONLY)
MAIL 6330 N. Primrose, Temple Cit
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS P Y
ABSORPTION SYSTEM, BTU CITY TEL. NO., 287-2263
AIR HANDLING UNIT, CFM CONTRACTOR Bryant Heat. & Air Cond. Inc.
ADDRESS 1350 East Las Tunas
BOILER, HORSEPOWER
1 COMPRESSOR, HORSEPOWER 3-ton 5 00 CITY San Gabriel TEL. LIC.
286-1141
LICENSE NO. 221751 CLASS C20
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
1 FURNACE: FAU x GIj�4)(ITx
FLOOR BTU ,�JJ 0 5 00 INSPECTION RECORD
HEATER: SUSPENDED UNIT >
WALL
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NEW-ADDITION- PERMIT $ 3 00
ALTER REPAIR_ TOTAL FEE $ 1 00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT� E ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORD.NAN ES AN LAWS REGULATING HEATING,VENTI-
LATINS, AIR C DIT 0 APPROVALS TE PECTOR S GNATURE
I HEREBY ERT HAT I M NO ACTING IN VIOLATI.O OF ROUGH
CHAPTER 9, IV 3F H SINESS AND PROFESS NAL FINAL
CODE OF THE FCA 0 '
SIGNATURE / JACK R. ALLEN, SUP VISING CHANICAL ENG'R.
OF PERMIT T E � '
PERMIT VALIDATIO CK� M.O. CASH
PLAN HECK VALIDA7 -
uu,.7
0 0.2 N°'SEP 14 41 D 1
3.00- Q
!-EE BACK OF APPLICATIONFOR COMPLETE FEE SCHEDULE
WORKERS'COMPENSATION DECLARATION 76A364C pp //A� g N PERMIT
I hereby;affirm that I have a' certificate of consent to self CE-818(2-80) +L���B`1 N ®p�g ®.� ft Ir! ��
incur or a certificate of Workers'Compensation Insurance,o'r HEATING-VENTILATING-AIR CONDITIONING
a c ified copy thereof(Sec.3800,Lab.C.)
s
Policy No. Company
❑ Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN BUILDING
department. ADDRESS 6330 Primrose
Date Applicant (PRINT OR TYPE ONLY)
CERTIFICATE OF EXEMPTION FROM WORKERS'
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Temple City
COMPENSATION INSURANCE NEAREST }
CL
(This section need not be completed if the work involved ABSORPTION UNIT, BTU CROSS-ST. Longden 0
by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. PROCESSED BY U
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM �'(� Cr_permit is issued, I shall not employ any person in any manner t 0
so as to become subject to the Workers'Compensation Laws. BOILER, BTU F-'
12/13/ Fred A. Gasper APPROVALS DATE INS TOR'S NA URE W
Date p f COMPRESSOR,BTU `�' ad ROUGH N
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM Z
Exemption, you should become subject to the Workers' FINAL
Compensation provisions of the Labor Code, you must forth-
EVAPORATIVE COOLER VALID ON
with comply with such provisions or this permit shall be '
deemed.revoked. FURNACE: FAU VWo
LICENSED CONTRACTORS DECLARATION FLOOR: BTU
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. 370098
License Number Lic.Class ' Ca0
contractorFre.d A. GaspDee 12/13/88
❑ I am exempt from the licensing requirements as I am 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 1 3 2 4 A
Lic.or Reg.No. Date TOTAL FEE -
# o 0 0 0 0 8
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT 0 0 3 (1 5 0
I hereby affirm that I am exempt from- the Contractor's NAME
License Law for the following reason (Section 7031.5, Busi- 0 0 0 3(1 5 0 C5
ness and Professions Code): ADDRESS
❑ t., as owner of the .property, will do the work and the CITY TEL.NO. I 2 14-88
structure is not intended or offered for sale (Section
7044,Business and Professions Code).
❑ OWNER Greg & Pam Kniep
I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project ; MAIL 6330 Primrose
(Section 7044,Business and Professions Code). ADDRESS
CONSTRUCTION LENDING AGENCY CITY Temple City TEL.NO. 286-6773
I hereby affirm that there is a construction lending agency CONTRACTOR Ht & A
for the performance of the work for which this permit is Fred A. Gasper g• /
issued(Sec.3097,Civ.C.).
Lender's Name ADDRESS 535 E. Camino Real
Lender's Address CITY Arcadia No.
Arcadia 574=7551
1 certify that I have read this application and state that theSTATE 370098 LIC. C20.
above information is correct.I agree to comply with all County LICENSE NO. CLASS
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 properly for
ipection purpo. s.
I nattTre o Permute Date