HomeMy Public PortalAbout5721 ROSEMEAD BLVD_Mechanical__ COURTY'OF IAS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1002090002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
]LEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
] ON FILE ] 5721 ROSEMEAD BL ]
] FEE DESCRIPTION: QUANTITY: UOM: AMOUNT-1 TEMP CA 91780 ]
]ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS ]
15397-012-043 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl
1 102 COMPRSR < 100 KBTU 2.00 COM 54.00 1 1
TENANT: 08 FURNACE/HEATER <100 2.00 UNI 54.00 [ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
YOSHINOYA TEMPLE CITY STORE 30 AIR INLETS/OUTLETS 20.00 UNI 87.00 102/09/10 SR 02/09/11 1
I 140 EVAPORATION COOLERS 3.00 UNI 65.70 1 1
]OWNER: TEL. NO: 141 VENTILATION FAN 1.00 FAN 15.75 ]FINAL A FINAL BY: CODE: ]
IYOSHINOYA AMERICA, INC. (310) 527-6060- 143 COMM KITCHEN HOOD 2.00 HOD 130.80 1 ]
1991 W. KNOX ST. 145 PROD CONVEY DUCT SYS 2.00 SYS 130.80 I I
ITORRANCE CA 90502 147 ALTER EXIST DUCT SYS 1.00 SYS 27.00 IDSSCRIPTION OF WORK I
I 170 PC INDIV COMM HOOD 2.00 HOO 505.80 IT.I. REMODEL EXISTING RESTAURANT REMOVE EXISTING KITCHEN I
TOTAL FEES 1,098.60 IHOODS AND PROVIDE NEW KITCHEN HOODS EQUIQPMENT ARE EXISTING ]
(APPLICANT: TEL. NO: 1 IREPLACE TWO HVAC WITH NEW ONE WITH SAME SIZE CAPACITY ONLY *I
1MIZUNO (213) 487-9964- 1 1
12917 TEMPLE ST. 1 ISPECIAL CONDITIONS:'
]LOS ANGELES CA 90026 I ]
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ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I
ISHIN SHIN CONSTRUCTION CORP. (626) 279-7991- 1 1 1
19324 E GARVEY AVE #J LIC. NO I IFAU/WALL FURNACE {�, }]
IEL MONTE CA 91733 858568E I �( r
I 1 (COMBUSTION AIR OPENINGS 1 ] I
[ARCHITECT OR ENGINEER: TEL. NO: I . , IDUCT WORK I
(ATELIER-U (213) 487-9964- 1 1 ]
12917 TEMPLE STREET LIC. NO: 1 IAC/COMPRESSOR �] 1
ILOS ANGELES, CA 90026 NONE
I THERM03TAT I 1
1 I (FIRE DAMPERS I I ]
I (SMOKE DETECTION DEVICES 1 I 1
1 1 (COMMERCIAL HOOD I I 1
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IREPORT ID: DPR264 ROUTE TO: BS0508 I I I
WORKER'S. COMPENSATION DECLARATION 20-0046 DPW 9/89
I hdreby affirm that I have a certificate of consent to self Insure, MAS64C APP ICA ON FOR PERMIT LIME G REEN
or a certificate of Worker's Compensation Insurance, or a certified
copy thereof(See.3800 Lab.C.) -1 HEATING-VENTILATING-AIR CONDITIONING
party CASuA141(il
�,PoIlcyNo./C5e//;"U—, _4W"*Lr1 (;OUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
51 Certified copy Is hereby furnished.
❑ Certified copy is filedithtt>�bullding inspection FOR APPLICANT TO FILL IN BUILDING -7
department. (PRINT OR TYPE ONLY) ADDRESS L2
Date 10 ;-PX 9 Zr Applicant LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE e5a,?e
CERTIFICATE OF EXEMPTION FROM WORKERS' *Wd NEAREST I or-
COMPENSATION INSURANCE levwe_-5 CROSS ST. 1=� Lz��
(This section need not be completed If the work Involved by the -ABSeRP+"UNIT,BTU--1 gga—,P,& ASSESSOR
permit Is for one hundred dollars($100)or less.) PARCEL
AIR HANDLING UNIT.CFM MAP BOOK PAGE [
DISTRICT NO, PROCESSED BY
I certify that In the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to BOILER.ST
become subject to the Workers'Compensation Laws.
COMPRESSOR,BTU /1.+. .2!5*'
Date Applicant APPROVALS DATE INSPECTOR'S SIGNATURE
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM ROUGH
Exemption,you should become subject to the Workers'Compensation
provisions of the Labor Code,you must forthwith comply with such EVAPORATIVE COOLER 147 5_0 FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU—GRAVITY—
LICENSED CONTRACTORS DECLARATION FLOOR —BTU VALIDATION
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED—UNIT—
(commencing with Section 7000)of Division 3 of the Business and HEATER,
Professions Code,and my license Is In full force and effect. WALL ACCT.Or
�4707 317.70
License Number 30el-33 Lic.Class el- ✓ a
ACCT.ir
0
Contractor AllZom-1- &A—.5 a /-e IEF ZIO I, 32 OR 699.20(
I am exempt under Sec. Plan check fee 0 2' ITEM;;. 3
B.&P.C.for this reason PERMIT ISSUING FEE$..7AI TOTAL 11317.00
-==bI TOTAL FEE ;7 CHECK 11117.Vu
Signature I
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT CHANGE
I hereby affirm that I am exempt from the Contractor's License Law NAME
for the following reason(Section 7031.5, Business and Professions 001.
Code): ADDRESS❑ OOM-01101 12/22
1, as owner of the property, or my employees with wages
as their sole compensation, will do the work and the CITY TEL.NO. 7194 1 AM 9:413
structure is not Intended or offered for sale(Section 7044,
Business and Professions Code). OWNER
E:]
1, 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 Issued 6�
(See.3097,Civ.C.). 4;s wo
ADDRESS Fee
Lender's Name
r's Address CITY TEL :3 J^.) 915,-y
Lendefy J41
— I STATE .
I cerci that I have read this application and state that the above LICENSE NO. CLASSLIC
✓
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
property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF APPLICANT OR AGENT — DATE