The URL can be used to link to this page

Home My Public Portal About6264-6276 ROSEMEAD BLVD_Mechanical__ WORKERS' CI have certificate of cons APP CATT O^n FOR PERMO � I hereby affi-rm that I have a certificate of consent to-self � �L (J`YJ a Insure, or a certificate of Workers' Compensation Insurance, HEATING - VENTILATING - AIR CONDITIONING or a certified copy thereof Sec 3800, Lab C ) 76A36AC 0, �r CE-818(REV 10/81) 0 0 Comp. , - Policy No wC N Company j1Alayh Its Certified-copy Is hereby furnished ;• COUNTY OF COS'ANGELES. BUILDING AND SAFETY ❑ Certified copy Is filed with the county building inspec- FOR-APPLICANT-TO FILL IN ' BUILDINGc� /C tion department (PRINT OR TYPE ONLY) ADDRESS 1" �"(6��g Applicant f LOCALITY J � ERS' 'Date �-t t, ' NO TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WOR NEAREST COMPENSATION INSURANCE" V an( �1 CROSS ST (This,sectlon need not be completed Wthe work Involved by ABSORPTION UNIT, BTU U V DISTRICT NO PROCESSED BY the permit Is For one hundred dollars ($100)or,l-ess,) AIR HANDLING UNIT, CFM 1 certify that in the performance of the work, for 'Asch this L V b permit Is Issued, I shall not employ any person In any manner BOILER, BTU so•as to become subject to the Workers'Compensation Laws t 'l APPROVALS DATEPE s SIGNATURE Dote Applicant COMPRESSOR, BTU Lodd(j ROUGH NOTICE TO APPLICANT .If, after making this Certificate of VENTILATION SYSTEM FINAL Exemption, you should become subject to the Workers' J '� 7 Compensation provisions of the Labor Code,-you must'forth- EVAPORATIVE COOLER (60ooeF01) VALIDAT N with comply with such provisions or this permit shall be deemed revoked - , FURNACE FAU GRAVITY— LICENSED RAVITY a{ r/' S 3�]\ LICENSED CONTRACTORS DECLARATION FLOOR BTU dd►/► ` / 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 WALL and Professions Code, and my license is in full force and effect - :— 01 License Number 7'� L�� Llc 'Class__ fW_ - Q Contractor �tkL6ate t] 0 ❑ I am exempt and r Sec _ _ _ _ Plan check fee h B&P C for this reason CA PERMIT ISSUING FEE s^ U Date �'2 7 2 7 A Signature TOTAL FEE OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I hereby affirm that I am exempt from the Contractor's License D I -1 37.00 Law for the following reason (Section 7031 5, Business and NAME, Professions Code) ❑ I, as owner of the property, or my employees with ADDRESS •'°,1 'J 7,0 0 wages as their sole compensation,will do the work arid the structure is not Intended or offered for sale(Section CITY TEL NO 08, 1 6-785 7044, Business and Professions Code) OWNER SAI ❑ I,"as owner of the property, am exclusively contracting (( , with licensed contractors to construct the project (Sec- MAIL ADDRESS () OS�vi^� �'Vd ' -tion 7044, Business and Professions Code) , CONSTRUCTION LENDING AGENCY CITY VW �� ' TEL NO' ' I hereby affirm that there is a construction lending agency for ` the performance of the work,for which this permit is Issued CONTRACTOR E4 h� (Sec 3097, Civ C ) • ADDRESS Lender's Name ) 101 •rer 4 CITY TEL NO Lender's Address l • STATE r�c LIC r] I certify that I.have read this application and state that'the LICENSE NO /J q CLASS above 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 I upon the above-mentioned property for inspection purposes SEE REVERSE FOR-EXPLANATORY LANGUAGE- / Signature of Applicant or nt Date - 1 COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 - MECHANICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1302270015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 _ PHONE (626) 285=0488 EXT ILEGAL ID FEES PAID BUILDING ADDRESS _ I ITR 5904 LT 15 _ I - r 6272 ROSEMEAD BL f 1 - - IFEE DESCRIPTION _ QUANTITY UOM AMOUNT TEMP CA 917801560 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LONGDEN _ 15384-005-001 - 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE '596 GRID H2 LOCALITY TEMPLE CITY CAI 1 130 AIR INLETS/OUTLETS 2 00 UNI 8 80 - ITENANT 132 APPL VENT (OTHER) 1 00 UNI 12 90 (ISSUED ON PROCESSED BY PLAN BY - 1 147 ALTER EXIST DUCT-SYS 1 00 SYS 27 00 102/27/13 SR _ ' I TOTAL FEES 76 50 (OWNER _ - R TEL NO , I - - _I FINAL DATE Y FINAL BY - CODE 1LI, WAN XING - - (626) 623-2479- 16272 ROSEMEAD BLVD ITEMPLE CITY CA 91780 - - SCRIPT):Olf OF WORK I I (ALTERATION OF EXIST DUCT SYSTEM, 2 AIR INLETS AND VENT (APPLICANT TEL NO - lZHENG, KEN - (626) 674-2.338= 11352 CARVIN AVE ' - - - ISPECTAL CONDITIONS ,I I ROWLAND HTS CA 91748 ICONTRACTOR TEL NO, - - (APPROVALS - - DATE- INSPECTOR SIGNATURE 1 IMIRACLE DEVELOPMENT INC (626) 674-2338- 11352 CARVIN AVENUE - LIC -NO r _ - IFAU/WALL FURNACE I_-" ROWLAND HEIGHTS CA 91748 _ 928751 I 1 1 (COMBUSTION AIR OPENINGS ARCHITECT OR ENGINEER• TEL NO i _ - DUCT WORK LIC NO J IAC/COMPRESSOR I- ITHERMOSTAT I I I - I - - • I - I � I I I _ = I FIRE DAMPERS- ISMOKE DETECTION DEVICES I COMMERCIAL HOOD I - _ ' 1 - - I I• I - I I I I I I I IREPORT ID DPR264 ROUTE TO BS0508 I I I I I I - WORKERS'COMPENSATIGNDECLARATION AIf"ll-L�OC/Klll �ON 2®R PERMIT I I hereby affirm that I have a certificate of consent to self If ll- tb 11 CJ lT lllS9!!tl I Insure, or a certificate of Workers' Compensatton Insurance, I ' ,HEATING -VENTILATING - Aid CONDITIONING or a certifi d copy thereof (Sec 3800, Lab C ) 76A364C i ' �5 y a 417, CE-818(REV 10/81) P❑olc No Company �RemoYT i Certified copy Is hereby-furnished - COUNTY OF LOS ANGELES BUILDING AND SAFETY Ce`tified copy is filed with the county building mspec- FOR 'APPLICANT TO FILL IN - BUILDING n tion department (PRINT OR TYPE ONLY) ADDRESS Date q LOCALITY \ NO TYPE OF-APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTI FROM WORKERS' NEAREST t,'�-h•COMPENSATION INSURANCE CROSS ST R. ,t', ABSORPTION UNIT, BTU DISTRICT NO PROCESSED (This section need not be completed if the work involved by , the permita"s'fo one hundred dollars'(5100)or less.) �' ^. - AIR HANDLING UNIT, CFM I certify that'In•the performance of the'work for which this permit Is tssued',2IshoWnot employ any person In any manner ' �-'•' BOILER, BTU so as to becomersuLiject to The Workers'Compensation Laws APPROVALS DATE INS TOR'S SIGNATURE ' Date �L' Applicant COMPRESSOR, BTU _ A ROUGH NOTICE TO APPLICANT If, after makmg this,Certificate of VENTILATION SYSTEM FINAL aj Exemphon,`fy`ou,;should become subject to the' Workers' CompensatlonEprovisions of the Labor•Code, you must forth- / EVAPORATIVE COOLER C� VALIDATION with comply.with' such provisions or this permit shall be a deemed revoked', FURNACE FAU '-GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU' I hereby affirm,that•I am licensed under provisions of Chapter 9 SUSPENDED - UNIT HEATER (commenang:`wrth Section 7000) of Division 3 of the Business, t WALL ,and Professions Code,and"my license is'in full force and effect i�ccy P V V K Com/ 0- License NJ,m"'ber.:-� D�2 d Llc Classt��3 U Im Date' / 0 ❑ ;, I am exempt under Sec r w' ,r Plan check fee r7 H B &P C�fdr.this reason Z PERMIT ISSUING FEE $ Date 'TOTAL FEE Slgnatuie,''r' " ,:'O NER-BUILDER DECLARATION PLAN CHECK APPLICANT :'�Y r ;92864-AI hereby a4ilri hat I am exempt from the Contractor's License Law for theffollowing reason (Section 7031 5, Business and NAME Trip, D # 0 0 0 0,0 8 Professions,Code) R,,'" V 1 °.. 43.5 0' ElI, as ow,nec ADDRESS of the property, or my employees with wages;'as,thelr sole compensation,will do the work and, CITY - TEL NO !, 0 0 0 4-3.5 0 V the siruc{ure'is not intended or offered for-sale(Section, � f�V� 7D 4 7044„Business and Professions Code) 0 506785 '.I OWNER• I ❑ I, as;pwr-&"6f the property, am exclusively contracting y( /r 1 M e with-licensed contractors to'construct the project (Sec- MAIL tion17044; Business and Professions Code) ADDRESS ""CONSTRUCTION LENDING AGENCY - - Uc7ay a ,-• _ CITY'� '� ,' TEL NOS� , ! i I hereby dffir.m that there Is a construction lending agency for the perforrrian e,of the work for which this permit Is Issued CONTRACTOR (Sec 3097 GL C') 4"� 1- ►. Q "'f� ADDRESS Saoto T -Il � �. 4. Lender's Narver CITY TEL NO Lender's Addresst, Y STATE AA LIC. I certify thanl:have read this application and state that the LICENSE-NO S�/ - CLASS /jp ty3 aboveinfo'r`mation Is correct I agree to comply with all County ordinance"";and"State laws relating to building construction, �'j3 32 •4�3 and hereby authorize representatives of this County to enter upon the above`- ti ,menoned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 6 s13� ` ignature of"Applcant or Agent Dote - '" '•' "' - ' ' 'ik,!Am�th COMPENSATION DECLARATION ANF ��pAMN FOR PERMH mhe su*, or&certif carte of Worke s' Compensatioa certificate of n ent to Insuran elf LL l� )J�"J or a certified copy thereof (Sec 3800, Lob ) 76A364c'~ HEATING - VENTILATING, - AIR CONDITIONING CE-818(REV 10/81) Policy No Company Certified copy is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ Certified copy is filed with The county building inspec- FOR APPLICANT TO FILL IN BUILDING tion depart ent % (PRINT OR TYPE ONLY) ADDRESS Date Applicant NO TYPE OF APPLIANCE OR EQUIPMENT .' FEE LOCALITY ERTI KATE OF EXEMPTION ROM WORKERS' NEAREST COMPENSATION INSURANCE CROSS ST (This section need not be completed if the work involved by ABSORPTION UNIT, BTU DISTRICT NO PROCESSED BY 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 _ U permit is issued, I shall not employ any person in any manner s'o'ds to become subject io the Workers'Compensation Laws BOILER, BTU APPROVALS DATE SP TOR SIGNAYRE Date Applicant COMPRESSOR, BTU ROUGH — NOTICE TO A00CANT If, after making this Certificate of VENTILATION SYSTEM FINAL Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code,'you must forth- EVAPORATIVE COOLER VALIDATI N with comply with such provisions or this permit shall be 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 with Section 7000) of Division 3 of the Business WALL and Professions Code,and my license is in full force and effect y 4641,5A O Licens um e 1?97e76Lic ass D U Q # • 0 0 0 2 2 O Contract ate Q • •.1 L 5,0 V ❑ I am exempt under-Sec W Plan check fee �� 1 2 5 0 B &P C for this reason o 0 0 p Date 7 PERMIT ISSUING FEE p 1,2 7-87 Signatur TOTAL FEE 12,21166 ER-BUILDER DECLARATION PLAN CHECK APPLICANT L(� I hereby affirm that I am exempt from the Contractor's License' D Law for the following reason (Section 7031 5, Business and NAME Professions Code) El1, as owner of the property, or-my employees with, ADDRESS NQ /s ay\ wages as their sole compensation,will do the work and CITY the structure is not intended or offered for sole(Section - CITY TEL N NO 7044, Business and Professions Code) ❑ _ OWNER AAn I, as owner of the property, am exclusively contracting C. with licensed contractors to construct the project (Sec- MAILRESS. � J Tion 7044, Business-and Professions Code)' ADD CONSTRUCTION LENDING AGENCY CITY TEL NO 'O lL[_ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued- CONTRACTOR - - - (Sec 3097, Civ C ) ADDRESS L'ende}'s Name CITY TEL NO _ Lender's Address STATE LIC I certify that I have read this application and state that the LICENSE NO CLASS above information is correct I agree.to comply with all County ordinances and State laws relating to building construction, *candthhreby authorize representatives of this County to enterabove-menti d ro prt nspection p rposesSEE REVERSE FOR EXPLANATORY LANGUAGE Applicant or Agent Doe �•' '-•' - - - - '-'