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Home My Public Portal About5707 ROSEMEAD BLVD_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0210290006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGALD: FEES PAID BUILDING ADDRESS: ON FILE 5707 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY 47 ALTER EXIST DUCT SYS 1.00 SYS 27.00 TENANT: TOTAL FEES 54.75 ISSUED ON: PROCESSED-BY: P R 5 10/29/02 JK 04/27/03 . OWNER: TEL. NO: FINA DA E FINAL BY: CODE: 3709C INVESTMENT - 0 - SAN DIEGO, CA9211137 DESCRIPTION OF WORK EXTEND DUCT SYSTEM APPLICANT: 0- INF BUILDERS (626) 574-0138- 120 W CAMINO REAL SPECIAL CONDITIONS: ARCADIA 91007 - CONTRACTOR: TEL. NO: s APPROVALS DATE INSPECTOR SIGNATURE INF BUILDERS (626) 574-0138- •,' Z 120 W CAMINO REAL LIC. NO w` ',' '!. / L FURNACE ARCADIA CA 91007 490547BHIC /Jj \ COMBUSTION AIR OPENINGS ARCHITECT OR E G ER: TE 0: DUCT WORK LIC. NO: i, - - AC COMPRESSOR THERMOSTAT FIRE DAMPERS SMOKE ECT ON C - COMMERCIAL HOOD REPORT ID: DPR264 ROUTE TO: BS0508 WORKER'S COMPENSATION DECLARATION 20-0046 DPW 9/89 r®� P�19�� I hereby affirm that I have a certificate of consent to self insure, 76A364C APPLICATION or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING copy thereof Sec.3800 Lab.C.)yi PoTic`Y - ��'t%ompany t& 7� ;;r�� LI COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. Certified copy Is hereby furnished. ❑ Certified copy is filed with the county building In ction ��_////��//_// ; FOR APPLICANT TO FILL IN UILDING ADDRESS 5 'department. �7/�// (PRINT OR TYPE ONLY) Date �-,rZ'CIApplicant r , • Lam/' V I LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPT ON FROM WORKERS' NEAREST T. COMPENSATION INSURANCE CROSS ABSORPTION UNIT,BTU ASSESSOR (This section need not be completed if the work Involved by the I MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT CFM DISTRICT NO. PROCESSED BY I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to BOILER,BTU "/ � fy become subject to the Workers'Compensation Laws. � 6 94e:e�� COMPRESSOR,BTU APPROVALS DATE INSPECTOR'S SIGNATURE Date Applicant VENTILATION SYSTEM NOTICE TO APPLICANT: If, after making this Certificate of I PROUGH Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER / provisions of the Labor Code,you must forthwith comply with such FINAL provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION Lf I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: ' SUSPENDED—UNIT— (commencing USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business and WALL Professions Code,and ddrmy liiicclense• is in full force and effect. License Number 7as90/dLID.Class 6-SP 6Z0 ® =� } Id� I'VE Mem 3-Z--tel r Contractor � Date ' ` °� � ❑ _ C I am exempt under Sec. Plan check fee B.&P.C.for this reason I PERMIT ISSUING FEE$ tEMS C Date: vZ. 5 O A*' 5�. CA � u TOTAL FEE Signature PLAN CHECK APPLICANT ' 1EsN52.956 i.'+`i U OWNER-BUILDER DECLARATION f1UA4,jr" I hereby affirm that I am exempt from the Contractor's License Law NAME st _ for the following reason(Section 7031.5, Business and Professions ga- J0e(-9 Code): IfQ ❑ ADDRESS S f7 7 S�fat Q I Lr S i I 1 _r ��= I, as owner of the property, or my employees with wages l;lil -�,II �!i:) as their sole compensation, will do the work and the CITY / f TEL.NO. O'' { ; 1. structure is not Intended or offered for sale(Section 7044, AI'1'�" '' Business and Professions Code). OWNER ❑ I, as owner of the property, am exclusively contracting MAIL with licensed contractors to construct the project (Sec- ADDRESS tion 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY TEL.NO. I hereby affirm that there is a construction lending,agency for CONTRACTOR the performance of the work for which this permit is issued (Sec.3097,Civ.C.). ADDRESS Lender's Name CITYVTEL. 61*9_ Lender's AddressSTATE I certify that I have read this application and state that the above CENSE NO. 7QQ�O7 LIC. information is correct. I agree to comply with all County ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon the above-mentioned p erty for inspecti ur o es. SEE REVERSE FOR EXPLANATORY LANGUAGE 3-2- 9� WORKER'S COMPENSATION DECLARATION 20-0048 DPW 9/89 I hereby°affirm thflt•1 have a certificate of consent to self insure, 764C APPLICATION FOR PERMITLIME GREE!] or a certificate of Worker's Compensation Insurance,or a certified HEATING-VENTILATING-AIR CONDITIONING copy thereof(Sec.3800 Lab.C.) Poll cy No��3S �0 Company&. �` �� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. ❑ Certified copy Is hereby furnished. ❑ Certified copy is filed with the county building In ction FOR APPLICANT TO,FILL IN BUILDING'Po pF dep rtmen (PRINT OR TYPE ONLY) ADDRESS Date �� f r Applicant LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST �� rQ T_� COMPENSATION INSURANCE CROSS ST. ABSORPTION UNIT BTU oi ASSESSOR' (This section need not be completed if the work involved by the MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM DISTRICT NO. PROCESSED BY I certify that In the performance•of the work for which this permit is Issued, I shall not employ any person in any manner so as to BOILER BTU become subject to the Workers'Compensation Laws. dpf K6�� COMPRESSOR,BTU . -+ Date Applicant VENTILATION SYSTEM APPROVALS DATE y]NSPECTOR' NATURE NOTICE TO APPLICANT: If, after making this Certificate of ROUGH A AT Exemption,you should become subject to the Workers'Compensation {" EVAPORATIVE COOLER provisions of the Labor Code, you must forthwith comply with such � FINAI. provisions or this'permit.shall be deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION? I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED UNIT y (commencing with Section 7000)of Division 3 of the Business and HEATER: WALL A�•C I e4r Professions Code,and my license is in full force and effect. d 132lilcle 59, License Number k ? r'g-Z Lie.Class 14.2. i'E:d E '�f�uc,. t��c- a�.lt` � T�:(�AL 1i7fl,C�_� o Contractor Date %HES . 1_ (� (� L i S o L' ❑ I am exempt under Sec. Plan check fee113 'J�-� _ D B.&P.C.for this reason PERMIT ISSUING FEE$ � O t t L F Date: TOTAL FEE .•..�5 I 2V 16/9 U is —lI.lj_. L n Signature , , ;U, OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT �(/r ��` F � 1 Ate +S■l=jra I hereby affirm that I am exempt from the Contractor's License Law NAME (� , for the following reason (Section 7031.5, Business and Professions V Code): ADDRESSX/ l+ ❑ I, as owner of the property, or my employees with wages ��J —' as their sole compensation, will do the work and the CITY Q��G TEL.NO structure is not intended or offered for sale(Section 7044, U Business and Professions Code). OWNER ❑ I, as owner of the property, am exclusively•contracting' lCt� MAIL M y�J with licensed contractors to construct the project (Sec- ADDRESS L tion 7044,Business and Professions Code). Y CONSTRUCTION LENDING AGENCY CITY �� C/( TEL.NO. 1 hereby affirm that there is a construction lending agency for CONTRACTOR,P , the performance of the work for which this permit is Issued v (Sec.3097,Civ.C.). ^ ADDRESS /,f� /Z / � Lender's Name CITYQ � ! TEL.NO. .3:3 y,00 Lender's Address STATE LIC. I certify that I have read this application and state that the above LICENSE NO. G P„Z CLASS ,� information is correct. I agree to comply with all County ordinances and State laws relating to building construction,and hereby authorize represent tiv of this County to enter upon the above-mentioned pr y 1 sp tiWENT S. SEE REVERSE FOR EXPLANATORY LANGUAGE Sle E OF AP DATE ' WORKEWS.COMPENSATION DECLARATION 20.0046 DPW 9189 '•"'�' APPLICATION FOR PERMIT �� %E E N I hereby-affirm that I have a certificate of consent to self insure, 76A3I or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING copy thereof(Sec.3800 Lab.C.) Policy No. Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. ❑ Certified copy is hereby furnished. ❑ Certified Copy is filed with the county building Inspection FOR APPLICANT TO FILL IN BUILDING department. (PRINT OR TYPE ONLY) ADDRESS Date ApplicantLOCAL[ NO. TYPE OF APPLIANCE OR EQUIPMENT FEE , CERTIFICATE OF EXEMPTION FROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST. ABSORPTION UNIT BTU ASSESSOR (This section need not be completed if the work Involved by the MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM DISTRICT NO. PROCESSED BY I certify that in the performance of the work for which this permit I is Issued. I shall not employ any person in any manner so as to BOILER,BTU become subject to the Workers'Compensation Laws. COMPRESSOR,BTU y APPROVALS DATE INSP R'S SIGNATURE Date Applicant VENTILATION SYSTEM �� 90 NOTICE TO APPLICANT: If, after making this .Certificate of ROUGH Exemption,you should become subject to the.Workers'Compensation V Z provisions of the Lobar Code, you must forthwith comply with such L�IAR6FIafG6AetER�� w O FINAL ' provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT (commencing with Section 7000)of Division 3 of the Business and WALL Professions Code,and my license is In full force and effect. Al,0S d ; License Number LID.Class a,C :-ti•E �x r C Contractor Date i y ❑ • I am exempt under Sec. Plan Check fee - 33A1311 *-L� ?I C B.&P.C.for this reason '' PERMIT ISSUING FEE$ f� z i I E _ O Date: TOTAL FEE /� 7a l O-TAL 212 70 u Signature CHECK 212.70 • OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT VCHANGE .00!0 2 I hereby affirm that I am exempt from the,Contractor's License Law NAME , for the following reason(Section 7031.5, Business and Professions Code): ADDRESS ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work and the CITY TEL.NO. yl�G� y)ie �j structure Is not intended or offered for sale(Section 7044, Business and Professions Code). OWNER LTA ❑ I, as owner-of the property, am exclusively contracting MAIL with licensed contractors to.'construct the project (Sec- ADDRESS tion 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY CI TEL.NO. I hereby affirm that there is a construction lending aw. gency for CONTRACTOR , the performance of the• ork for which this permit s Issued (Sec.3097,Civ.C.).. ADDRESS -� - Lender's Name CITY Z/ TEL.NO. -, Address I certify hatI have read this application and state that the above LICENSE LIC. SE NO. �p�� n �7 CLASS 4 Information is correct. I agree to comply.with all County ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon the above-mentioned A operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT DATE