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Home My Public Portal About5760 RIO HONDO AVE_Mechanical__ Y' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0309220019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL • ES B D TR: 6561LT: 761 UN: .002 5760 RIO HONDO AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802432 ASSESSOR INFOR14ATION NUMBER: NEAREST CROSS STREET: WORKMAN 8587-004-023 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY 30 AIR INLETS/OUTLETS 1.00 UNI 4.35 TOTAL FEES 32.10 PROCESSED : PL E . 09/22/03 JK 03/20/04 ' OWNER: TEL. 0: FLNAL DATE FINA BY: CODE: MEHTA;YATRIK (626) 975-3249- 5760 RIO HONDO AV TEMP 917802432 DESCRIPTION OFF-01119- DUCT F RDUCT FOR ADDITION APPLICA EL. 0: SAME AS OWNER SPECIAL CONDITIONS: ALEJANDRO CUETO CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO FAU/WALL FURNACEFA/WA COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER: TEL. NO: DUCT WOR CUETO, ALEJANDRO R (323) 788-1892- 3716 BECK AVE. LIC. NO: AC/COMPRESSOR BELL, CA 90201 NONE THERMOSTAT FIRE DAMPERS SMOKE DETECTION S COMMERCIAL OOD REPORT ID: DPR264 ROUTE TO: BS0508 �. 'WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT ' I he�,'bby•affirm that I have a certificate of consent to self insefe, or a certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified'copy thereof Sec. 3800, Lab. C.) 76A364C 040438 CE-818(REV. 10/81) Policy No. NKN29N Company Nnrthhrnnk Certified copy is hereby furnished. 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 5760 Rio Hondo Date 5 25-B5—Applicant I..�. .. LOCALITY Temple Cit NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION'INSURANCE CROSS ST. ABSORPTION UNIT,BT.0 3,`' = (This section need not be Completed If the work Involved by DISTRICT NO. PROCESSED BY the permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM 'O I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner BOILER, BTU so as to become subject to the Workers'Compensation LOWS. APPROVALS DATE INSP TO S SIGNAT Date Applicant 1 COMPRESSOR, BTU _ 3A HP 10 00 ROUGH ✓ NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL Exemption, you should become subject to the Workers' ✓ Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATI N with comply with such provisions or this permit shall be deemed revoked. - FURNACE: FAUN—GRAVTY LICENSED CONTRACTORS DECLARATION l. FLOOR •_BTu__6a 10100 I hereby affirm that I am licensed under provisions of Chapter 9 HEATER:. SUSPENDED—UNIT— "(commencing USPENDED UNIT'(commencing with Section 7000)of Division 3 of the Business WALL and Professions Code,and-my license is in full force and effect. z 1 9.S 3 # License Number 363290 Lic. Class C-20 ® o 0 0 0 0 O Temp-Air Htg. d a 4 6 2 5 09 Contractors A/C Date 9-30-86 ❑ I am exempt under Sec. Plan check fee h BAP.C. for this reason' PERMIT ISSUING FEE$ 10 50 Date: TOTAL FEE Signature OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031.5, Business and NAME Professions Code): , ❑ I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and CITY TEL. NO. the structure is not intended or off&L-d for sale(Section 7044, Business and Professions Code). OWNER ❑ I, as owner of the property,am exclusively contracting Dave Russell Construction with licensed contractors to construct the project (Sec- MAIL tion 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY CITY 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 Temp—Air Htq. & A/C, Inc. (Sec. 3097, Civ. C.). , ADDRESS 601-A W. Lambert Rd. Lender's NameCITY a Habra, a. Lender's Address 213-694-4881 I certify that I have read this application and state that the ATE uT LICENSE NO. 363290 CLASS C-20 above information is correct. I agree to comply with all County ordinances and State laws relating to building construction, and h by authorize representatives of this County to enter up thb aboare-ment'�ned prop rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE AJn pril 23, 1985 Signature of Applicant or Agent Date