HomeMy Public PortalAbout9647 VAL ST_Mechanical__ WORMER have a certificate of
7 erg APPLICATION _FOR PERMIT LIME GREEN
I hereby affirm that I have a certificate of consent to Bell Insure
or a certificate of Worker a Compensation Insurance or a certifies HEATING-VENTILATING-AIR CONDITIONING
copy thereof 1134 c) i/ //
p., No No Company /!G 7LL� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
CemOed copy is hereby furnished
❑ c�erklled ncwy U rued with the county bulkh inapectlon FOR APPPLLICCANT TOFILLIN BUILDING6 y V a
A PRINT ORY) ADDRE5
Date Applicant ��I'n NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY •"T
CI
CERTIFICATE OF EXEMPTION FROM WORKERS CROSS ST � e L t .
COMPENSATION INSURANCE
(This section need not be completed B the work Involved by the ABSORPTION UNIT BTU
ASSESSOR
parfaitIs for we hundred dollars($1010)or lead) AIR HANDLING UNR MAP BOOK PAGE PARCEL CFM galgCTrq peOL.�em.
I certify [het In the performance of the work for which this permit �DO
is Issued I shell not employ any person In any manner so as to BOILER BTU
become subject to the Workers Compensation Lewy
COMPRESSOR BTU
Date Applicemuvnovua DAM sav�mcas SxuuTuae
VENTILATION SYSTEM
NOTICE TO APPLICANT If after making this Certificate of ROUGH
Exemption you should become subject to the Workers Compensatron EVAPORATIVE COOLER
r provisions of the Labor Code you must forthwith comply with such FINAL
provisions or this Permit shall be deemed revoked FURNACE FAU_
LICENSED CONTRACTORS DECLARATION FLOOR BTU VALIDA ON
I hereby affirm that 1 am licensed under provisions of Chapter 8 HEATER SUSPENDED UNn_
(commencing with Section 7000) of Division 3 of the Business and WALL
Professions Code and my license Is infullforce and effff�ecct� �a S E/Gc+1r�G {r 49
an
License Number 06'.•5-97" "Lk Claae
/nQQ,,gqnal;6t n�(� �1 � ► G.
Canbe 19 Dale - /- d
O
❑ I am exempt under Sec Plan check tee
Q
B SP C for this nation PERMIT ISSUING FEES O (��(j„ O
e TOTAL FEE 3�OJ `�� ` U
-MMA+ W
Signature OWNER BUILDER DECLARATION PLAN CHECK APPLICANT l AL
ITEMS N
I hereby affirm that I am exempt from the Contractor a License Law NAME , 141 AL 97 - 9C ?
97 - 9 ,-
for following reason(Section 7031 5 Business and Professions CHECK
-7.9
9 r `t
r-1AOQREBS
I as owner of the property or my employees with wages jHM6E j'h}
as their sole compensation will do the work and the CRY TEL NO
structure is not intended or offered for sale (Section 7044
Buslnees and Proleaabns Code) OWNER
❑ ,
I ea owner of the properly em exclusively contracting MAIL / Il1J[IjJ-[I�I'I1 11/1?�54
with licensed contractors to construct the project (Sec MAILADDRESS 1Q St, ??69 1 F.C11i'�o
iron 7044 Bualness and Proffuelona Code)
CONSTRUCTION LENDING AGENCY CRV TEL NO
I hereby affirmanon that there lea for
ch this
sperlending agency for CONTMCTOR ' r Q P'*/`r Irl In ,
the performance of the work for which thio permit Ps issued i
(Sec 3087 Civ C 1 q/ A r
Lender a Name ADDRESS So 7 r3 (0 , n trvf_rrj-;.r
CITY TEL N C _
Landers Address
STATE
1 certify that I have read this application and state that the above LICENSE NO G 910(01rel 5'9 CCiwSS -}O
mformetlon is correct I agree to corrrply with all County ordmancea
and State laws raising to budding construction and hereby aulhoi ze
representatives of this County to enter pon the above mentioned
property for Inspection p posse SEE REVERSE FOR EXPLANATORY LANGUAGE
�� it-nM
BpIM'nUrB O APPll0ANI011 AO i DAM
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0412060007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR: 16867 LT 6 9647 VAL ST
FEE DESCRIPTION QUANTITY LON AMOUNT TEMP CA 917800000
ASSESSOR INFORMATION NUMBER. NEAREST CROSS STREET TEMPLE CITY BLVD
5383-013-006 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE GRID LOCALITY TEMPLE CITY, C
02 COKPRSR < 100 KBTU 1 00 COM 27 00
TENKNI 08 FURNACE/HEATER <100 1 00 LIN1 27 00 -
30 AIR INLETS/OUTLETS 3 00 UNI 13 D5 12/06/04 JK 06/04/05
41 VENTILATION FAN 1 00 FAN 15 75
OWNER TnUr-WE FINAL BY CODE
VALENZUELA MANUEL A,GUIDALUPE (626) 447-9680- TOTAL FEES 110 55
9647 VALLEY ST
TEMP 9178OG000
AIR CONDITIONING AND HEATING SYSTEM
APPLICANT TEL NO.
DREAM ROME CONSTRUCTION (626) 677-7069-
SPECIAL CONDITIONS.
CONTRACTOR- TEL NO APPROVALS DATE lospn7m-TrWan—
DREAM HOME CONSTRUCTION (626) 285-4421-
6323 LIVIA AVE LIC NO FAU/WALL FURNACE
TEMPLE CITY, CA 91780 7448548
MaTm AIR OPENINGSARCHITECT OR ENGINEER TEL. No DUCT WORKe
LIC. NO XE7EMMSSDR -
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVIffEr
COMMERCIAL HOOD
• ADDITIONAL DATA ON FILE
REPORT ID• BPR264 ROUTE TO BS0508