HomeMy Public PortalAbout5773 ROSEMEAD BLVD_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0305130006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: S PAID BUILDING SS:
ON FILE 5773 ROSEMEAD BL
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780
ASSESSOR 0 N BER: NEAREST CROSS STREET: LAS TUNAS
5397-012-043 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
30 AIR INLETS/OUTLETS 4.00 UNI 17.40
TENANT: 41 VENTILATION FAN 3.00 FAN 47.25 ISSUED ON: PROCESSED Y: PLAN BY: EXPIRES ON:
BANK OF EAST ASIA TOTAL FEES 92.40 05/13/03 JK 11/09/03
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
377LU9C INVESTMENT
t7
SAN DIEGO, CA9211137 DESCRIPTION OF WORK
TENANT IMPROVEMENT FOR BANK
APPLICANT:
JOHN GONG (714) 368-9881-
28071 IRVINE BLVD SPECIAL CONDITIONS:
TUSTIN 92780
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SINGPOLI HOP KIN CONSTRUCTION AND (714) 368-9881-
DECORATION NEVADA INC LIC. NO FAU/WALL- FURNACE
28071 IRVINE BLVD 761247 B
TUSTIN, CA 92780 COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: L. 0: C OR S Z�
LIC. NO: AC COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKEDETECTION DEVICES
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508
DECLARATI
WORKER'S COMPENSATION of consent to zaoda6DPW efee APPLICATION FOR PERMIT LIME
� 76A384C
I-hereby affirm that I'have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING
ZP.11N'o.e
1�7t% company .S��f l r fu/fin COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING ANDSAFETY DIV.
ertified copy is hereby furnished.'
❑ Certified copy is filed with the county p buildingInspection FOR APPLICANT TO FILL IN BUILDING'
department. (PRINT OR TYPE ONLY) ADDRESS
Date &18 Applicant 6 %i 6A)02 LOCAL
ITY e,
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION-FROM WORKERS' NEAREST
CROSS
COMPENSATION INSURANCE
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($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person In any manner so as to BOILER,BTU ��
become subject to the Workers'Compensation Laws.
COMPRESSOR,BTU
APPROVALS DATE INSPECTO ' IGNATLRE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of ROUGH
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
ly 1.1—
provisions of the Labor Code, you must forthwith comply with such FINAL
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDATION
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED UNIT
(commencing with Section 7000)of Division 3 of the Business and HEATER: WALL
Professions Code,and my license is in full force and effect.
License Number
4174? ,2 Lic.Class d
Contractor
I)A —72 . Date
,e, r ;�?:•.,_.�
Plan check fee
I am exempt under Sec.
BAP.C.for this reason PERMIT ISSUING FEE$ 6fi I I( �
F
Date: TOTAL FEE ! � L
Signature I
OWNS ILDER DECLARATION PLAN CHECK APPLICANT (CHH ;F, -K 4t j(
I herebyaffirm that I am exempt from the Contractor's License Law H•N ' !;
o NAME 2 �.=st, o I_•.
for the following reason (Section 7031.5, Business and Professions •� '
Code):
❑ ADDRESS C•�P LI /L_ 80
1, as owner of the property, or my employees wlth.wages I l.•i I _i:•�;�I - a �:
as their sole compensation, will do the work and the CITY TEL.NO. '�{
M r At24 �2�� 8c�%2g7
structure is not intended or offered for sale (Section 7044, i "='•+z
Business and Professions Code). OWNER j Y" r l l o i-
❑ I, as owner of the property, am exclusively contracting MAIL
with licensed contractors to construct the project (Sec- ADDRESS 4 "c) &,n za_e)2y7
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITYTEL.NO( -11q0^
I hereby affirm that there is a construction lending agency for CONTRACTOR
the performance of the work for which this permit Is issued 'jt
(Sec.3097,Civ.C.).
ADDRESS �/J
Lender's Name
CITY �_f 1(2.41� TEL.NO.(.21J622-7277
Lender's Address �/
I certify that I have read this application and state that the above STATE'
NO. 3) 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
property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF APPLICANT OR AGENT DATE