HomeMy Public PortalAbout5846 SULTANA AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1101270018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID
BIIILDING ADDRESS: 1
ITR: 5905 LT: 99 1 1 5846 SULTANA AV I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I TEMP CA 917801838 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 1
15387-015-015 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl
102 COMPRSR < 100 KBTU 1.00 COM 27.00 1
TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 11SSUED ON: PROCESSED BY: PLAN BY:
I 130 AIR INLETS/OUTLETS 2.00 UNI 8.70 101/27/11 SR
I 141 VENTILATION FAN 1.00 FAN 15.80 1 I
1OWNER: TEL. NO: 1 TOTAL FEES 106.30 IFI TE FI CODE: 1
ING, EUGENE (626) 201-0911- 1 1 I
15846 SULTANA AV I I I
ITEMP 917801838 [ IDESCRIPTION OF WORK 1
I [ (INSTALL HVAC SYSTEM
(APPLICANT: TEL. NO: I I
ING, EUGENE (626) 201-0911- I I
15846 SULTANA AVE I ISPECIAL CONDITIONS: [
TEMPLE CITY CA 91780
I I I I
(CONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
ING, KIN W. (626) 201-0911- 1 1 I
ILINDA C. NG LIC. NO 1 IFAU/WALL FURNACE I I I
P.O. BOX 1725 NONE 1 I I I I
TEMPLE CITY, CA 91780 1 ICOMBUSTION AIR OPENINGS I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 (DUCT WORKI I-
I 1 [
I
LIC. NO: i JAC/COMPRESSOR I I I
I 1 (THERMOSTAT I I I
FIRE DAMPERS I I I
I 1 (SMOKE DETECTION DEVICES I I I
1 iCOMMERCIAL HOOD I I I
I I I I I I
I I I I I I
I I I I I I
1 I I I I I
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I [REPORT ID: DPR264 ROUTE TO: BS0508 I I I
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WORKER'S COMPENSATION DECLARATION20.0048 DPW 9/89
I hereby affirm L at I have a certificate of consent to self insure, 7840 APPLICATION FOR PERMIT MKvE GREEN
or a cenificilte of Worker's Compensation Insurance, or a certified HEATING-VENTILATING-AIR CONDITIONING .
copy thereof(Sec.3800 Lab.C.)
Policy No. 0 I lztRompany COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
Certified copy is hereby furnished.
❑ Ce 'fled co is filed with the count building Inspection FOR APPLICANT TO FILL IN BUILDING
Py Y 9 P ADDRESS Air
ep rt_e t. (PRINT OR TYPE ONLY)
Date ApplicantLOCALITY �!
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE .
CER FICATE OF EXEMPTION FROM WORKERS' NEAREST
CROSS ST.
COMPENSATION INSURANCE ABSORPTION UNIT,.BTU- - -ASSESSOR
(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.) AIR HANDLING UNIT,CFM
DISTRICT NO. P ESSED By
I certify that in the performance of the work for which this permit (,D
is issued, I shall not employ any person in any manner so as to BOILER,BTU /5_Q�
become subject to the Workers'Compensation Laws. .
COMPRESSOR,BTU "� v"`�
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 G VITY
-LICENSED CONTRACTORS DECLARATION t 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 license i full force and effect.
�
License,Number , Lic.Class�� `�!�_✓ �D
g a
la
Contractor V ate .5jaL
T°a CC',
❑ Plan-check fee
I am exempt under Sec. o .3�� 90
e.&P.C.for this reason PERMIT ISSUING FEE 1 ITT12,
Date: TOTAL FEE .. ,��a TOTAl. lid a
Signature a°Ist`y
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT' C t!
17
L
1 hereby affirm that I am exempt from the Contractor's License Law NAME ,
for the following reason(Section 7031.5, Business and Professions i C►
Code): ADDRESS
❑ I, as owner of the property, or my employees with wages °t
as their sole compensation, will do the work and the CITY TEL.NO, Off/
structure is not Intended or offered for sale(Section 7044, a
Business and Professions Code). OWNER
❑ 1, as owner of the property, am exclusively contracting MAIL
with licensed contractors to.construct the project (Sec- ADDRESS
tion 7044,Business and Professions Code).
CITY TEL..NO.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for CONTRACTOR ,
the performance of the work for which this permit is Issued
(Sec.3097,Civ.C.).
ADDRESS
Lender's Name
CI TEL.NO. -
Lender's AddressSTATE LIC: /� p
I certify that I have read this application and state that the above LICENSE NO. CLASS G—Ld
information is correct. I agree to comply with all County ordinances
and State laws relating to building construction,and hereby authorize
represeritives of this County to enter upon the above-mentioned
proer or Inspection S.
/ SEE REVERSE FOR EXPLANATORY LANGUAGE
SI E APPLI OR AGE ATE /�/