HomeMy Public PortalAbout5612 ROSEMEAD BLVD_Mechanical__ COUNTY OF IAS ANGELES TEMPLE CITY 0 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS ME 0508 1105040022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS
ON FILE 1 5612 ROSEMEAD BL
IFEE DESCRIPTION QUANTITY DOM AMOUNT I TEMP CA 917801849
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
15387-028-016 01 PERMIT ISSVANCE PEE 27 BO 1 THOMAS PAGE 596 GRID H4 LO('ALITY TEMPLE CITY, C1
30 AIR INLETS/OUTLETS 6 00 UNI 26 10 1
I TENANT 32 APPL VENT (OTHER) 1 00 UNI 12 80 11SSVED ON PROCESSED BY PLAN BY 1
11SH KITCHEN RESTAURANT 47 ALTER EXIST DUCT SYS 1 00 SYS 27 00 105/04/11 SR 1
I I TOTAL FEES 93 70 1 1
10WNER TEL NODAT 'E FIBY CODE
THAN, DDC X (213) 792-8583- i I
534 6 DEWEY AVE
SAN GA13RIEL CA 91776 SCR PTION OF YORK
(TENANT IMPROVEMENT-MECHANICAL
APPLICANT TEL NO
NGUYEN FRANK (626) 523-0366-
11711 MAGELLEN RD SPECIAL CONDITIONS
WEST COVINA CA 91797
I I
1CONTRACTOR ]
TEL NO JAPPROVALS DATE INSPECTOR SIGNATURE
]STC CONSTAOCTION CORPORATION (626) 286-1669- 1I
19089 OLIVE STREET LIC NO i FAU/WALL FURNACE 1 1
]TEMPLE CITY, CA 91780 6849548
I I 1GGMBD$TIGN AIR OPENINGS 1
1ARCHITECT OR ENGINEER TEL NO 1 (DUCT WORK I 1
INGUYEN, FRANK (626) 523-0366- 1
yp!
11711 MAGELLAN ST LIC NO 1AC/COMPRESSOR
(WEST COVINA CA 91789 NONE
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
1 COMMERCIAL HOOD
I I 1 I I I
I
I I I i I
I I f 1 I I
I I I I
1 IREPORT ID DPR264 ROUTE TO BS0508
I
WORKERS COMPENSATION DECLARATION APPLICATION FOR PERMIT
I hereby affirm that I have a certificate of consent to self
insure m a certificate of Workers Compensation Insurance HEATING - VENTILATING - AIR CONDITIONING
or a certified copy thereof (Sec 380000 Lob C )
L C�rT.n11 818(REV 10/81)
Policy Nd�Compam + �-
Certified copy is hereby furnish d L COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy Is filed with the unry bu ding inspec FOR APPLICANT TO FILL IN BUILDING /
tion deportment ADDRESS
������.'.'.`,� �p�� (PRINT OR TYPE ONLY)
�t�{-'--F/-�LJPPPIicont LOCALITY
r Pl NO TYPE Of APPLIANCE OR EQUIPMENT FEE
ERTI CATE OF EXEMPTION FROM WO ERS' NEAREST
COMPENSATION INSURANCE CROSS ST
(This sactlon needat h
re complNed R the wo Involved by ABSORPTION UNIT BTU DISTRICT NO PROCE D e
the permit Is for one hundred dollars ($100)or less )
I certify that in the performance of the work for which this AIR HANDLING UNIT CFM
permit Is issued I shall not employ any person In any manner
so as to become subject to the Workers'Compensation Laws BOILER BTU APVROVALS DAT[ IN CTO SIGNA RIs
Date Applicant COMPRESSOR BTU ROUGH
NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM FINAL ^Z
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth ) EVAPORATIVE COOLER O VALIDATI N
with comply with such provisions or this permit shall be 1
deemed revoked FURNACE FAU_GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU
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 Ay0Qhc�e\rn Ism full force and effect D y
License NNumberLsc Class , 00, V
Contrry�iI tp�, rD �' r 0
am exempt under Sec X094. 1 A C
V W
B 8P C for this reason Plan check fee O'sd
PERMIT ISSUING FEE $ I • - 45.50
I TOTAL FEE
Signature Dote
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT • • • 4 5 5 0 5
I hereby affirm that I am exempt from the Contractor s License I a 1 9 c 8 8
Law for the following reason (Section 7031 5 Business and NPJAE
Professions Code)
❑ I, as owner of the property or my employees with
ADDRESS0442 ILk
r
wages as their sole compensation will do the work and CITU T
the structure Is not intended or offered for sale(Section :1 0 9 4.2 A
7044 Business and Professions Code) '
OWNER # • •i•i• 2 3
Elas owner of the property am exclusively contracting
with licensed contractors to construct the project (Sec ppRE55 I • •11 a a
ton 7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY CITY _ •r• •ni 5 0 0 5
I hereby affirm that there Is a construction lending agency for
the performance of the work for which this permit Is Issued CONTRACT ► IQ 19-88
(Sec 3097 Civ C )
ADDRESS
Lender's Name
CITY
Lenders Address
STATE
Iy that 1 ha read this application and state that the LICENSE NO CLASS
amformotio s correct I agree to comply with all County
onces and ate laws relating to building construction
and)reby au orize representatives of this County to enter
ua obov -mentioned property for Ins (tion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature o pt nt or Agent �.