HomeMy Public PortalAbout5551-5551 1/2 SANTA ANITA AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0206210018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 44319 LT: 1 UN: 5 5551 1/2 SANTA ANITA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802912
ASSESSOR INFORMATION NU MBE NEAREST CROSS STREET: LIVE OAK
8573-020-046 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: 03 LOCALITY: TEMPLE CITY
08 FURNACE/HEATER <100 1.00 UNI 27.00
TENANT: TOTAL FEES 54.75 -ISSUED 0 : PROCESSED 8 AN B : EXPIRES 0 :
06/21/02 JK 12/18/02
OWNER: TEL. NO: FI ATE INAL BY: CODE:
YEE;NATHAN -
5551 1/2 SANTA ANITA
TEMP 917802912 CRP ON OF WORK
REPLACE HEATER
ELPPA NET (818) 988-8110- 1
23725 ROSCOE SPECIAL CONDITIONS:
WEST HILLS 91304
CONTRACTOR: TEL. NO: APPROVALS ATE INSPECTOR S G AT RE
EL PAYNE (818) 988-8110-
23725 ROSCOE BLVD LIC. NO FAU/WALL FURNACE
WEST HILLS CA 91304 120228/C20 «�
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: 0: DUCT WORK
LIC. NO: AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKE C O D C
COMMERCIAL OOD
I
REPORT ID: DPR264 ROUTE TO: BS0508
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT
I hereby.offirm that I have a certificate of consent to self
insure,s°r a certificate of'Norkers'Compensation Inso'nce, } FIEATING - VENTILATING - AIR-CONDITIONING
' or a certified copy thereof(Sec. 3800, Lab. C.) 76A364C
CE-818(REV. 10/81)
policy NoiCompany y
❑ Certified copy is hereby fprnished.. COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN BUILDING
ADDRESS
tion department. (PRINT OR TYPE ONLY) ti
Date Applicant LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION FROM 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($100)or less.) AIR HANDLING UNIT,CFM U
S^ P
I certify that in the performance of the work for which this J 6
permit is issued,.l shall not employ any person in any manner BOILER,BTU
so as to become subject to the Workers'Compe LAWS. APPROVALS DATE INSPE TOR'S SIGN TORE
COMPRESSOR, BTU � �� GG 0 l(J " ROUGH
Date`191�C 44 Applicant L 01
NOTICE TO APPLICANT: If, after making 64sigrtificate of VENTILATION SYSTEM FINAL
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATI
ON
with comply with such provisions or this permit shall be ^ J
deemed revoked. FURNACE: FAU_L— RA IITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU U
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
'(commencing with Section 7000)of Division 3 of the Business - WALL
and Professions Code,and my license is in full force
and effect.
License Number3�`�s � Lic. Class`F' �A;2 ►/+'✓'�" i u
/ td
Contractor 5�6Date 7� -4 •o
❑ I am exempt u,/der Sec. ILU
J
Plan check fee
rL
H
B.&P.G. for this reason' PERMIT ISSUING FEE$ 0
te:
?�
Signature CY&1m&
TOTAL•FEE
OWNER-BUIL D RATION PLAN CHECK APPLICANT
I hereby affirm that I am ex pt from the Contractor's License
Law for the following reason (Section 7031.5, Business and NAME
Professions Code):
❑ I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and CITY TEL. NO.
the structure is not intended or offered for sale(Section
7044, Business and Professions Code).
OWNER
❑ I,'as owner of the property, am exclusively contracting MAIL
with licensed contractors to construct the project (Sec- ADDRESS 5 b 4 9 A
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITY TEL. NO. 0 0 0 0 a 8
I.hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued CONTRACTOR ( 0 0 4 4'S
(Sec. 3097;Civ. C.). ADDRESS a 0 a 4(( 5 0 v
Lender's Name ( Q, 1 5_86
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,
and hereby authorize a resentatives of this County to enter
rup th above- ne property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
s
Signature of App n o Agent Date