HomeMy Public PortalAbout9622 VAL ST_Mechanical__ • COUNTY OF LOS ANGELES TEMPLE CITY N 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0006020009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID- Frrg PA= BUILDING ADDRESS
TR 09285 LT 01 9622 VAL ST E
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 91780
ASSESSOR INFORMATION NUMBEF NEAREST CROSS STREET TEMPLE CITY
5383-014-005 02 COMPRSR < 100 KBTU 1 00 COW 27 00 THOMAS PAGE GRID LOCALITY TEMPLE CITY
08 FURNACE/HEATER <100 1 00 UNI 27 00
TENANT
30 AIR INLETS/OUTLETS 11 00 UNI 47 85 ISSUED ON PROCESSED BY PLAN BY EXPIRE
TOTAL FEES 101 85 06/02/00 UT 1 0
OWNER --Tn--vu- FINAL DATE CODE
V�ZA, VINCENT (626) 447-5548-VAL ST
TEMPLE CITY, CA
CHANGE OUT/RELOCATE HVAC SYSTEM
APPLICANT TEL NO
CONNOR AIR CONDITIONING (626) 286-3157-
4937 NORTH ENCINITA SPECIAL CONDITIONS
TEMPLE CITY, CA
CONTRACTOR —Tn—wu- ANGELES CO APPROVALS DATE INSPECTOR SIGNATURE
CONNOR AIR CONDITIONING (626) 286-3157- x,05 ��Tf^
4931 ENCINITA AVE LIC NO FAU/WALL FURNACE
TEMPLE CITY, CA 91780 403735 C20/ COMBUSTION ArW-6nTTffffr
ARCHITECT OR ENGINEER TEL NO DUCT �KAK
LIC NO 1111111
THERMOSTAT
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COMMERCIAL HOW
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Service Tha'L
REPORT ID DPR264 ROUTE TO BS0508
DEC
TION
WORKERS CI have ATION cafe of corse APPLICATION FOR PERMIT
I hereby affirm that I have a certificate of consent to self
insure, or a certificate of Workers Compensation Insurance,
or certified copy thereof (Sec 3500 Lab C ) 7&kWC HEATING - VENTILATING - AIR CONDITIONING
�� 04131( y /_Ac_Aq,C' k IsN0 CE 818REV to/Bt)
P❑ollcy o Compan
Certified copy is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified copy is filed with th county buil Ing mspec FOR APPLICANT TO FILL IN BUILDING �]/ ry��
tion department "C
(PRINT OR TYPE ONLY) ADDRESS ,/�"[�1�"�L? C V I71.
Date 5�1 r�b�applicant LOCALITY
I C.I
NO TYPE OF APPLIANCE OR EQUIPMENT FEE n
CERTIFICATE OF EXEMPTI FROM WORKERS' - NEAREST 't LI LU,/
COMPENSATION SURANCE CROSSST
(This section need not be comp If the work Involvad II ABSORPTION UNIT BTU oisialcr No ssEo e
the permit Is for onst hundred dollars (1150)or loss )
I certify that In the performance of the work for which this AIR HANDLING UNIT CFM Q /
permit Is issued I shall not employ any person in any manner
so as to become subject to the Workers Compensation Laws BOILER BTU Av VALS DATE IN s SIGNAm
Date Applicant COMPRESSOR BTU ROUGH
NOTICE TO APPLICANT If after making this Certdicote of VENTILATION SYSTEM FINAL
Exemption you should become subject to the Workers '
Compensation provisions of the Labor Code you must forth- EVAPORATIVE COOLER VALIDATI
with comply with such provisions or this permit shall be
deemed revoked FURNACE FAU VITY
LICENSED CONTRACTORS DECLARATION FLOOR e
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER SUBPENDED UNIT_
(commencing with Section 7000) of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect [ST O 3 2 0.313 A
License Nuumsbeers_4(&g4 eI`/ Liz: Clan ��/ ..p ► I . : ; ;,;151
2 5 7 5 V
Contractol-sF s�`wNyAl(iJi�—kk_ S�'r/.7 � ) CL] O
e e e2575i5
I am exempt under sec Plan check fee 0 5 1 IL-85
1116
B BPC for this reason PERMIT ISSUING FEES 15-
SU z
Dore
Signature TOTAL FEE 5
OWNER BUILDER DECLARATION PLAN CHECK APPLICANT
I hereby affirm that I am exempt from the Contractor s License Pooy
Law for the following reason (Section 7031 5 Business and NAME L L l �It I-kl ' 1,' -
Professions Code) C I, L/� �i
ElEI as owner of the property or my employees with ADDRESS r IkA u C-TrAi 1/i`
wages as their sole compensation will do the work and CITYPML y TEL NO 4.1'17 ZLl
the structure is not mtended or offered for sola Sectionprp
7044 Business and Professions Code) I `^
OWNER v 1"s
❑ I as owner of the property am exclusively contracting . /I
with licensed contractors to construct the project (Sec MAIL
s LZ r y�L)—
tion 7044 Business and Professions Code) YY7
CONSTRUCTION LENDING AGENCY CITYI L TEL NO
I hereby affirm that there iso construction lending agency for ,
the performance of the work for which this permit is Issued CONTRACTOR
(Sec 3097 Civ C ) % I L
ADDRESS
Lenders Name— (/
Lender s Address CI C f P. TEL NO[f • z-y
STATE LI
I certify that I have read this application and state that the LKENSE 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 '
+uthe abov menti ed property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
>Applicant or Agent Dole