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HomeMy Public PortalAbout6039 SULTANA AVE_Mechanical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS ME 0508 0301240009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D• FEES PAID BUILDING ADDRESS: TR: 5904 LT: 295 BL: .001 6039 SULTANA AV FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917801550 ASSESSOR OR ER: NEAREST CROSS STREET: GARIBALDI 5384-016-025 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY 02 COMPRSR < 100 KBTU 1.00 COM 27.00 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED 0 L S . 30 AIR INLETS/OUTLETS 4.00 UNI 17.40 01/24/03 JK 07/23/03 . TOTAL FEES 99.15 OWNER- TEL. 0: FINAL DATE FINAL BY: CODE: LANA THUY DANG (626) 390-9646- 6039 SULTANA AV %,x-03 TEMP 91780 DESCRIPTION OF WORK HVAC SYSTEM FOR GUEST HOUSE PPL 0: SAME AS OWNER - SPECIAL COND TIONS: GE CCOONNTRAACTOOIR::ER TEL. NO: - ®C� ©�J���� APPROVALS DATE INSPECTOR SIGNATURE LIC. NOFAU/WALL FURNACE COMBUSTION AIR OPENINGS I ARCHITECTOR G 0: �' r \ C PATRICK CHIU AND ASSOCIATES (626) 308-991 1238 S GARFIELD AVE LIC. NO• v— AC/COMPRESSOR til�];1 11 ALHAMBRA, CA 91801 NONE – THERMOSTAT U J U n CW OrL J'flFIR DAMPERS IILIA-�;L11 U ILJ�L�ILJI( SMOKE DETEC 0 E IC S p - COMMERCIAL HOOD Z7 0 1 •• ,. r ,1 ❑ v� SerVIC����Z ' REPORT ID: DPR264 ROUTE TO: BS0508 'VI;ORKERSt COMPENSATION DECLARATION APPLICATION P P L I,EfP+dL T I O N F® pR PERMIT C®A I T ;I'hereb#affk�rm that I have a certificate of consent to self @@��dxft® m�! 11� CIf:�V! -insure, Qr a certificate of Workers'Compensation Insurance, HEATING - VENTILATING - AR CONDITIONING or a certified copy thereof(Sec. 3800, Lab. C.) 76A364C CE-818(REV. 10/81) V 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 Aq� Le tion department. (PRINT OR TYPE ONLY) ADDRESS Date Applicant LOCALITY T 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. PROCES e the permit is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM t S 1/Jd�) 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner BOILER, BTU so as to become subject to the Work rs'Compensati Laws.I A APPROVALS DATE INS CTOR'S GNATURE Date I Applicant COMPRESSOR,BTU ROUGH NOTICE TO APPLICANT: If, r aking this Certificate of VENTILATION SYSTEM FINAL Exemption, you should come subject to the Workers' Compensation provision of the bar Code, you must forth- EVAPORATIVE COOLER A ID T with comply with such provi ns or this permit shall be deemed revoked. -9 FURNACE: FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT �} R '(commencing with Section 7000)of Division 3 of the Business ® WALL %'� o U and Professions Code,and my license is in full force and effect. 0 License Number Lic. Class Contractor Date ❑ I am exempt under Sec. Plan check fee A 6 2 S O A H BAP.C. for this reason # 0 0 0 0 0 8 PERMIT ISSUING FEE$ Signature Date: TOTAL FEE A v l a o20,50 OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT o 0 0 2 0,5 0 v I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and NAME 6L11'101l0e i i 01.02-87t Professions Code): C 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 6 7044, Business and Professions Code): ❑ I, OWNER 71 as owner of the property,am exclusively contracting r with licensed contractors to construct the project (Sec- MAIL ADDRESS 603-/ -s'� tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CITY TEL. NO. � u I hereby offirm 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 Lender'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, and hereby authorize representatives of this County to enter up n the above- nti }propert or inspecti� purpo SEE REVERSE FOR EXPLANATORY LANGUAGE Si ature of Applicant or Agent Date