HomeMy Public PortalAbout6239 ROSEMEAD BLVD_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9809150006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
GA D: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 84 6239 ROSEMEAD BL
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEOP CA 917801543
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5384-003-019 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
20 FIREPLACE < 100 KBTU 1.00 APL 27.00 09/15/98 VG 09/ 99
41 VENTILATION FAN 4.00 FAN 63.00
OWNER:' TEL. NO: TOTAL FEES 171.75 FINAL DAFT b FINAL By• CODE:
NGUYEN•BANG N. (213) 255-6206-
5625 HUB ST.
LOS ANGELES, CA DESCRIPTION OF WORKI
WALL HEATER FOR GUEST HOUSE AN STALL NEW A/C FOR
EXISTING HOUSE AND ADDITION
APPLICANT: TEL. 0:
SAME AS OWNER -
SPECIAL CONDITIONS:
P,r�,C�E9-ES C®
CONTRACTOR: TEL. NO: - ��� �My.� APPROVALS DATE INSPECTOR SIGNATURE
SAME ASLIC. NO FAU/WALL FURNACE
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
A & E DESIGNER, (213)6265288 -
LIC. NO: 1111111 AC/COMPRESSOR
NONE
THERMOSTAT
rLJ DD UC ��01 'K SJ FIRE DAMPERS
SMOKE DETECTIONDEVICES
O �fjI�, COMMERCIAL HOOD
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REPORT ID: DPR264 ROUTE TO: BS0508
WORKER'S COMPENSATION DECL%RATION 20.0048 DPW 9189 LIME G
I hereby affirm that I have a certifim'Tie of co�isent to self insure, 7GA364C APPLICATION FOR PERMIT
or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING
r coop thereof(Sec.3800 Lab.C.)
LFolicy!�ra�•� 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 ADDRESS �"� /J �{ >�.i (l
UILDING
department. (PRINT OR TYPE ONLY)
3 r LOCALITY 1� Cr 414
Date Applicant-T4) NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM WO ERS' NEAREST
CROSS ST.
COMPENSATION INSURANCE ABSORPTION UNIT,BTU ASSESSOR
(This section need not be completed if the work Involved by the MAP BOOKPAG PARCEL�9
permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to BOILER,BTU
became subject to the Workers'Compensation Laws. Q
COMPRESSOR,BTU
APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of ROUGH r
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code,you must forthwith comply with such FINAL 2
provisions or this permit shall be deemed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU VAJLID TION
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED-UNIT-
(commencing
USPENDED UNIT(commencing with Section 7000)of Division 3 of the Business and WALL ✓ J
Professions Code,and my license is in full force and effect.
License Number `,O /7L57 Lic.Class
Contractor. r1iDate Poo. C
❑ I am exempt under Sec. Plan Check f@@ 0
B.if P.C.for this reason PERMIT ISSUING FEE$ !� /5 F
Date: TOTAL FEE IA V
Signature___� /���
OWNE -BUILDER DECLARATION PLAN CHECK APPLICANT a
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 ACC!°Q
1, as owner of the property, or my employees with wages t
as their sole compensation, will do the work and the CITY TEL.NO. ,_307 4v°I�11
structure is not Intended or offered for sale(Section 7044, i r
Business and Professions Code). OW1 ITEMS
NER EMS
❑ I, as owner of the property, am exclusively contracting MAIL �I}�lEt yy= DID licensed contractors to construct the project (Sec- ADDRESS Q P
tion 7044,Business and Professions Code). CHECK 4301I:!
CONSTRUCTION LENDING AGENCY CITY TEL.NO. 7 °I.011i�•CHANGELL��CHANGE
I hereby affirm that there is a construction lending agency for ®
the performance of the work for which this permit Is issued CONTRACTOR s -S J
(Sec.3097,Civ.C.). [�
ADDRESS i G
Lender's Name 0000_0001 11 5/92
[STATE
c oZ7 63--5` 1 PM 11 o OFF
Lender's Address
I certify that I have read this application and state that the above SE NO. CLASS
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' spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
1 S
IGN 7l r. , no eneur T