HomeMy Public PortalAbout5519 SARA MAR LN_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY 0508MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ME 0508 9802170006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE (818) 285-0488 EXT
LEGAL ID: FEES PAID BU I LD ING-)MbWfgr—
ON FILE 5519 SARA MAR LN
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802528
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY
8588-010-024 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A3 LOCALITY- TEMPLE CITY
02 COMPRSR < 100 KBTU 1 00 COM 27 00
TENANT OB FURNACE/NEATER <100 1 00 UMI 27 00 ISSUED ON PROCessED BY PLAN BY EXPIRLS ON
TOTAL FEES 81 75 02/17/98 UT 02/17/99
OWNER TEL NO FINAL DATE -T= By CODE
DING GUO-PEI (000) 000-0000-
5519 SARA MAR LN 4-.V!f-,W
TEMP 917802528
EXCHANGE OF HEATING SYSTEM,ADD NEW AIR CONDITIONING SYSTEM
USE EXISTING DUCT WORK
APPLICANT TEL NO
ADVANCED AIR SYSTEMS (909) 466-8033-
12745 SUMMITT SPECIAL CONDITIONS
RANCHO CUCAMONGA,CA
5 g4GELES CoCONTRACTOR TEL 90
APPROVALS DATE INSPECTOR SIGNATURE
ADVANCED AIR SYSTEMS (909) 466-8033- �.� �T�-
12745 SUMMITT LIC NO FAp]QALL FURNACE
RANCHO CUCAMONGA, CA 91739 481200C-20
ARCHITECT OR ENGINEER TEL NO DUCT WORK
LIC NO 1111111
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FEW-965r—
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46//C' Service Th 'L
REPORT ID DPR264 ROUTE TO BS0508
�WORKI]RS COMPENSATION DECLARATION 76A364G APPLICATION FOR PERMIT
�S
1 hereby affirm that 1 have a cvrtificate of consent to self CE 618 (780) �ylu'I
insure Or n p) thereof(cate Workers Lab C canon Insurance or HEATING-VENTILATING-AIR CONDITIONING
a certified copy thereof(Sec 7800 Lab C j
Policy No Company
❑ Certifted copy ,s hereby furnished COUNTY OF LOS ANGEL BUILDING AND SAFETY
❑ Certified copy is filed with the county building inspection BUILDING
department FOR APPLICANT TO FILL IN
Uate Applicant (PRINT OR TYPE ONLY) ADDRESS � �A.v„. /� .✓f
CLRTII ICATE OP EXEMPTION FRO\t WORKERS NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY –/'�rfW �y
COMPENSATION INSURANCE NEAREST / _ }
(This Section Deed not be completed if the work Involved ABSORPTION UNIT BTV CROSS ST N7 _`O
by the p¢rmll IS for one hundred dollars ($IUB) Or less) DISTRICT NO r 'SES..+ V
1 certify that in the pLrformence of the work for which this AIR HANDLING UNIT CFM assl
permit is Issued I shall not emplu) any person ,n any manner /
so as to become subject to the Workers Compensation Laws BOILER BTU F
APPROVALS DATE INSPECTOR S SIGN JRE U
Date ApplicantW
COMPRESSOR BTU ROUGH i y
NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM 2
1 Xemption you should bec(nmc subject to the Workers FINAL
Compensation provisions of the Labor Code you must forth _
with comply with such provisions or this permit shall be EVAPORATIVE COOLER VA T
— k)deemed revoked FURNACE FAV— GRAVITY
LICENSED CONTRACTORSvDLLLARAFION FLOOR T BTU I
1 htreby affirm that I am licensed under provisions of Chapter HEATER SUSPENDED UNIT
9 (commencing with Section 7000) of Division 3 of the Bust WALL /000/O
ness and Professions Code and my license n in full force and
effect
Licenv.Number. Lin Class
Contractor. Date
❑ 1 am exempt from the licensing requirements as I am a
licensed architect or a registued professional engineer Plan Check fee 25%of above '
acting in my professional capacity (Section 7051 Bus '
mess and Professions Code) PERMIT ISSUING FEE $
•Lie or Reg No Date TOTAL FEE
HOML OWNER BUILDER DECLARATION PLAN CHECK APPLICANT - -
I hereby affirm that 1 am exempt from the Contractors
License Law for IhL following reason (Section 7031 5 Bus, -
ness and Professions Code) ADDRESS s!y �� . 2 0 9 x 4 A
1 is owner of the property will do the work and the �� ,
structure Is not intended or offered for iota (Section CITU /GALE—G!� TEL 1402t7„�J' 8
7044 Business and Professions Code)
❑
I as owner of the property am exclusively
ely contracting RAS 2 • 1 7,00
with licensed contractors to construLt the project MAIL
(Section 7044 Business and Profusions Code) ADDRESS 7�0 0 v
CONSTRUCTION LENDING AGENCY CITY TEL NO — 0 a 3 1 _8 1
I hereby affirm that there is a construction lending agency
for the performance of thi, work for which this permit is CONTRACTOR
Issued(Sec 3097 Ci, C)
Lender s NameADDRESS
Lender s Address
CITU TEL NO ,
1 certify that I have read this application and slate that the STATE LIC
above information is correct 1 agree to comply with all County I LICENSE NO CLASS
ordinances and Stan, laws regulating Heating Ventilating and
Air Conditioning, and hereby authouPe representatives of this SLF RLVERSI I OR EXPLANATORY 1 ANGUAGE
County to enter upon the above mentioned property for
wspecu
Signature
PmDe o! ttee Date