HomeMy Public PortalAbout5450 ROSEMEAD BLVD_Mechanical__ COUNTY OF UOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1006140016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 11218 LT 2 BL A 1 9010 BROADWAY
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802310
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
5388-003-003 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl
02 COMPRSR < 100 KBTU 2 00 CVM 54 00 1
TENANT 08 FURNACE/HEATER <100 1 00 UNI 27 00 ISSUEDON PROCESSED BY PLAN BY
TOTAL FEES 108 75 06/14/10 SR
OWNER TEL NO FI Dj/!H� Preiv BY CODE
SHBLL OIL PRODUCTS UE - � ��/V[T��/V\ ��/rypl
PO BOX 4935
(HOUSTON, TX 77210 IDESCRIPIION OF YORK
REPLACE 1 ETON A/C UNIT 1 3TON HEAT PUMP
(APPLICANT TEL NO
JACKSON, GREGORY S (951) 741-8941-
29804 OIFHORN RD SPECIAL CONDITIONS
MENIFEE CA 92586
(CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
]TOP NOTCH PLUMING AND HEATING AC- (951) 736-7980-
123215 TEMBSCAL CANYON RD LIC NO IFAU/WAL.L FURNACE
CORONA CA 92883 609613 C36
COMBUSTION AIR OPENINGS
1
ARCHITECT OR ENGINEER TEL NO DUCT WORK
LIC NO JAC/COMPRESSOR
THERMOSTAT
IFIRE DAMPERS
ISMgKE DETECTION DEVICES
COM4:RCIAL HOOD
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WORKLRS CONPLNSAI ION DLCLARA I ION- 76A364C APPLICATION FOR PERMIT
I hereby affirm that I hose a certificate of consent to self CE '81812801
insure ora certificate
pythereof( Wotkcr(Sec-
Compensation Insurance or HEATING-VENTILATING-AIR CONDITIONING
n certified copy thereof(Sec 3800 Lab C)
Policy No Company
Certified copy R hcrcby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified cop) IS filed with the counts budding inspectionUILDING
department FOR APPLICANT TO FILL IN
Date Applicant (PRINT OR TYPE ONLY) ADDRESS ,'� 'PI'✓LefG
Cl RTIFICATL Of EXEMPTION FROM WORKERS NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALIT QS� .� ( U
COMPLNSATION INSURANCLEAREST `
(This section need not be completed if the work Involved ABSORPTION UNIT BTU NROSS ST �A f f I, d-f a
by the permit is for one hundred dollars (S 100) or less) DISTRICT NOOCESSEO By U
1 certify that In the performance. of the work for which this AIR HANDLING UNIT CFM
permit Is Issued 1 shall not employ any person in ans manner X
so as to become subject to the Rorkers COmpcnsation Laws BOILER BTUU
APPROVALS DATE INSPECTOR a SIGNATURE
tit
Date Applicant COMPRESSOR BTU I� ROUGH
NOTICE TO APPLICANT If after making this Certificate ofVENTILATION SYSTEM FINAL �_� Z
Fxemption you should bLCOMC subject to the Workers
Compensation provisions of the Labor Code you must forth
with comply with such provisions or this permit shall be EVAPORATIVE COOLER VALIDATION
deemed revoked FURNACE FAU- GRAVITY_ � s
I ICENSI D CONTRACTORS DI.CLARATION FLOOR BTU
I herebv affirm that 1 am licensed under provisions of Chapter HEATER SUSPENDED UNIT
9 (commcnang with Sution 7000) of Division 3 of the Buss WALL
ness and Professions Code and my license Is in full force and
effect
License Number LIc Class
Contractor. Date
MI am exempt from the licensing reyulremcnis as I am a
licensed architect or a registered professional engineer Plan Cheek fee 25%Of above
acting In my professional capacity (Section 7051, Bus
mess and Professions Code) PERMIT ISSUING FEE $
LIc or Reg N� GQe� Date,/� �`j` _ TOTAL FEE
HOMI,OWNER BUILDER DFCLARAIIGN PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractors NAME
License, Iaw for the following reason (Section 7031 s Bust
ness and ProfcsSmns Code.) ADDRESS c 75 6 7 A
1 as owm.t of the propert) will do the work unit the
structure is not Intended or offered for sale (Section CITY TEL NO #' '� 8
7044 Business and Professions Code.) rs '
❑ OWNER
1 as owner of the property am exclusively contracting t! �h 2 1 a 5 0
with licensed contractors to construct the project MAIL .tel
(Section 7044 Business and Professions Code.) ADDRESS l � //t 1 /r' �iv R 5 Or—'
CONSTRUCT ION LLNDING AGENCY CITV _J�� TEL NO ,.�.7 1 1 '5_82
1 hereby affirm that there is a construction lending agency
for the performama, of the work for which this permit is CONTRACTOR y/-O
issued (Sec 3097 Civ C ) �J
Lender s Name ADDRESS // 0 Le,/77
Lender s Address CITY TEL NO
I certify that I have read this application and state that the STATEp LIC
abuse information n correct 1 agree to comply with all Count} LICENSE NO 7 CLASS
ordinances and Statelaws regv mg Heating Ventilating and
Air Conditioning and here a' th nz re presentutnes of this SEE RF VLRSL FOR EXPLANATORY LANGUAGE
County to enter upe i Ie at a mcntioncd property for
uispe On p ,.� ,
-DB�
Sismou a of ecrmtltee Jute