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Home My Public Portal About5553 RYLAND AVE_Miscellaneous__ • r ' BA3B4— EB,B-1'-"6B tAPPLICATION FOR PERM'IT4 1��/�� -JGc , HEATING - VENTILATING - AIR CONDITIONINt / COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER rADDRESS ILDING BUILDING AND SAFETY DIVISION JOHN A. LAMBIE. COUNTY ENGINEER 5.553 tlCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGCALITYFOR APPLICANT TO FILL IN o BEST. La Rosa Dr. IT (Print or type only) OWNER Brian Harrie No. TYPE,OF APPLIANCE OR EQUIPMENT FEE MAIL ADDRESS 5553 Ryland ABSORPTION SYSTEM, BTU CITY Temple City TEL. N0445-2119 AIR HANDLING UNIT, CFM CONTRACTOR Pacific Installers BOILER, HORSEPOWER ADDRESS 10920 E. Grand COMPRESSOR, HORSEPOWER CITY p TEL. NO. 1 VENTILATION SYSTEM LICENSE NO. 2116'98 CLASS DISTRICT NO. GROUP I ZONE PROCESSED BY EVAPORATIVE COOLER �r % �`� J FURNACE: f6GORSBTUa INSPECTI N RECORD a U HEATER: SUSPENDED UNIT �L WALL I to O /L (� O L: w O v: Z NEW—ADDITION— PERMIT $ 3 00 ALTER—REPAIR— TOTAL FEE S 1704 IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY L COUNTY ORDINANCES AND STATE LAWS REGULATING VENTILATING, AIR CONDITIONING. BY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION R 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL HE STATE OF CALIFORNIA. APPROVALS DATE INSPECTOR'S SIGNATURE RE ROUGH ITTEE FI NAL IDATION JACK R. ALLEN } OCK.. l .O. CASH SUPERVISING MECHANICAL ENG'R. .H�o 7 2 2 3 NOV 8 4 1 D '7.00- v •_��"CG CO�� 76A364E---nA 9r75 APPLICATION FOR PERMIT %' HEATING - VENTILATING - AIR CONDITIONING f BUIL G AND SAFETY DIVISION FOR APPLICANT TO FILL IN rN UILDING (PRINT OR TYPE ONLY) DDRESS �:' Y. Q' OCALITY NO. TYPE O F APPLIANCE OR EQUIPMENT FEE EAREST ROSS ST. ABSORPTION UNIT, BTU WNER AIR HANDLING UNIT, CFM MAIL ADDRESS BOILER, BTU p CITY {� 7 lfTEL. NO. e_� COMPRESSOR, BTU ,50 CONTRACT �t.•�� VENTILATION SYSTEM ADDRESS c,,o;z'e' / EVAPORATIVE COO!ZR CITY ' TEL. NOFURNA7 / FLOOR—BTU-CE: FAU tf—GRA ITY iC STATE LICE SE NO. � (� CLASS�'r/ r/ V � HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE ED BY �- WALL � 6 V • (J� r m a INSPECTION RECORD W u Ci- i G7 Z Plan check fee 25% of above. PERMIT ISSUING FEE $ 7 TOTAL FEE PLAN CHECK APPLICANT NAME ADDRESS CITY TEL.NO. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- LATING, AIR CONDITIONING. I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE OF CHAPTER 9, DIVISION 3, OF TN BUSINESS AND PROFESSIONAL CODE OF THE STATE OF LIFORN ROUGH SIGNATURE OF PERMITTEE FINAL !-7V PERMIT VALIDATION (el--PLAN CHECK VALIDATION CK. M.O. CASH " M.O. CASH 560tiDEG 241 D 1 9.50 == Q V� ION WOP�,tER'�.COMPENSATate of consent to 7BA346DPW9/89 APPLICATION FOR PERMIT `IME GREEN I hereby affiriu-Mat I have a certificate of consent to self Insure, 76A364C or a certificate of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING copy thAreof(Sec.3800 Lab.C-�-) Policy No.1!1 A -9ZuN�omPany-�lZ� Irri 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 \ I," I UILDING depa ment. (PRINT OR TYPE ONLY) Date Z Applicant �- C,,bN NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY 1 i 'IEAFIEST 'T� CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. lJ 1 S u� COMPENSATION INSURANCE I ABSORPTION UNIT,BTU (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.) I I 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 INSPECTOR'S SIGNATURE 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 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 licensee Is in full force and effect. License Number 2 - Lic.Class y Contractor — Data I ZZ , C EJI am exempt under Sec. Plan Check fee i" Q B.&P.C.for this reason PERMIT ISSUING FEE Q FC - Date: TOTAL FEE LL Signature Q OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT V, L hod 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, DDRES I, as owner of the property, or my employees with wages .,.7r =;j e 4� as their sole compensation, will do the work and the CITY TEL.NO. / 5¢ 1.`=3 structure is not intended or offered for sale (Section 7044, v i T.r C Business and Professions Code). OWNER _ ❑ 1, as owner of the property, am exclusively contracting MAIL TOTAL 3 - 4-5 with licensed contractors to construct the project (Sec- ADDRESS 1 I �4 L sl i y; � ��i EC tion 7044, Business.and Professions Code). �/� �// r S CONSTRUCTION LENDING AGENCY CITY (—r TEL.NO. 4`('Z9lb 4 iHA��` I CONTRACTOR hereby affirm that there is a construction lending agency for , the performance of the work for which this permit Is issued (Sec.3097,Civ.C.). ADDRESSF-dj ; L" W z= Lender's Name 0101'3-0031 l CTv �^ TEL.N j_i Lender's Addre I certify that I hay rea s appli tion and st at the above CENSE NO. 5 Z s CLCASS information is ct ree to co ply wit County ordinances and St r la g b ding ns Ion,and hereby authorize represent Ive th y to or upon the above-mentioned prope for' e s. SEE REVERSE FOR EXPLANATORY LANGUAGE 17, S&WURE OF16PPLICANT OR AGENT DATE