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76 A30.i. CE 818-1/75
APPLICATION FOR PERMIT
HEATING - VE-NTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS 5555' Wel land Apt B
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. Da I nes Dr
FOR APPLICANT TO FILL IN OWNER
-'4PRINT OR TYPE ONLY) Mr. Robert E Witney Sr
MAIL
NO TYPE&SIZE OF EQUIPMENTF E ADDRESS Welland Apt B
SEE BACK OF APPLICATION
FORCEA{RFURNACE, BTU 80,000 CITY Temple City TEL. No. LIIILFCOI20 '.
1 COMPRESSOR, BTU 24,000 CONTRACTOR E. L. Payne CO. '
ADDRESS 166 W. Live Oa k
VENTILATION FAN CITY Arcadia TEL. No. 447-6118.
LIST ALL OTHERS BELOW r STATE 1.20228 LIC. C-20
LICENSE NO. CLASS
1 attic fan DISTRICT NO. GROUP ZONE ROCE SED BY
INSPECTION RECORD
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Plan check fee. See reverse. z
PE.WNII I' ISSFING FEE S
FOTAL FEE A,
PLAN CHECK APPLICANT
NAN E
ADDRESS
CITY TEL.NO.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.COMPLY .
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
RO UG H
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSIN A! PROFESSIONAL FINAL 3_,),P:r-7
CODE OF THE STATE OF LIFORAI _
�OO;F
GNATURE PERMIT VALIDATION CK. M.O. CASH'
PERMIT E
PLAN CHECK VALI DAT ON CK, M.O. CASH
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76p,3!Iv!- CE 818-1/75
-," APPLICATION FOR PERMIT
' HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUI7EST
DEPARTMENT OF COUNTY ENGINEER ADD
BUILDING AND SAFETY DIVISION LOCTemple City
N EACRO -.Wildflower
FOR APPLICANT-TO FILL IN OWNER
(PRINT OR TYPE ONLY) Mr, and Mrs Whitney
-
NO. TYPE&SIZE OF EQUIPMENT MAIL
F=E ADDRESS Wel land
SEE BACK OF APPLICATION
CITY Tem l e City TEL. No. 444-0120 �.
1 FORCE AIR FURNACE, BTU �QO.Q.. 10 00
CONTRACTOR
COMPRESSOR, BTU 2900 10 00 - F_ I - PAYNF COMPANY
ADDRESS 6 W e Oak
VENTILATION FAN CITY Arcadia TEL. No. 446-6118
LIST ALL OTHERS BELOW STATE LIC.
LICENSE-NO. 120228 CLASS C-20
DISTRICT NO. GROUP ZONE PROC SED BY
INSPECTION RECOR '
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IL
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F-
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CA)
Plan check fee. See reverse. z
PERMIT IS.M.IN-C
TOTAL. 1 I;IS 27' 00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING. AIR CONDITIONING.
I HEREBY CERTIFY THAT ,I AM'NOT ACTING N VIOLATION - ROUGH
OF CHAPTER 9, DIVISION 3, THE BUSINESS AND FESSIONAL '_FINAL
CODE OF THE STATE DF CA FO NIA.
SIGNATURE - PERMIT VALIDATIOCCK. M.O. SH
OF PERMIT-
•
PLAN CHE VALID N CK. M�.O.n CASH
/�
�, � / UtiIU 0'27 on Cl, CH
WORKERS'COMPENSATION DECLARATION I CEA 86 BC(2-80) 'A P P l����� p�I� •�� MAT
I hereby affirm that I have a' certificate of consent to self
insure, or a certificate of Workers'Compensation Insurance,or 1' I-IEATONG-VENTILATING-AIR CONDITIONING
02006"My Y9reof(Sec.3800,Lab.C.)
Policy No. '77 company Ca.•'Cas•ua 1 ty• I ndemn i iy
❑ Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUI WING AND SAFETY
OCertified copy is filed with the county building inspection BOLDING
department. FOR APPLICANT TO FILL IN
Date —182-8 Applicant E, L- PAYNE COMPANYA (PRINT OR TYPE ONLY) , ADDRESS 555 •Wel land -.A t A
Q-18-8�
LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. TYPE OF APPLIANCE OR EQUIPMENT ' :FEE - Temple. City
COMPENSATION INSURANCE NEAREST }
(This section need not be completed if the work involved I ABSORPTION UNIT, BTu CROSS ST. Wildflower o
by the permit is for one hundred dollars ($100) or less.) DISTRICT NO. P E D BY 0
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM jl �q l/ 0'
permit is issued, I shall not employ any person in any manner CJQ O
so as to become subject to the Workers' Compensation Laws. I BOILER,BTU'
12-18-$0 E. L. PAYNE COMPANY APPROVALS DATE INSPECTOR'S SI TURE U
Date Applicant 1 COMPRESSOR,BTU .10 001L
ROUGH / to
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM.
-Exemption, you should become subject to: the Workers' FINAL.
Compensation provision's'of the Labor Code;you,must forth- EVAPORATIVE COOLER VALIDATION.
with comply with 'such' provisions or this permit shall be , ,
deemed revoked. ' FURNACE: FAU
LICENSED CONTRACTORS DECLARATION
1 FLOOR: eTU WSJ- 110 10 �0
I hereby affirm that I.am licensed under provisions of Chapter HEATER: SUSPENDED UNIT
9 (commencing with Section 7000)of Division 3 of the Busi-.. WALL
ness and Professions Code, and-my license is in full force and
effect. ,
License Number 120228 Lic.Class C-20
Contractor E; L° PAYNE Date 12-18-80 '
❑ I am exempt from the licensing requirements as•I am a
licensed architect-or.a registered professional engineer Plan Check fee 25%of above.
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code). PERMIT ISSUING FEE$ ' ] •'0Q
i
Lic.or Reg.No. Date TOTAL FEE 27 100
HOME OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I'
I hereby affirm that I.am exempt from-the Contractor's NAME
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code): ADDRESS
❑ I, as owner of the property, will do the work and the TEL.NO.
structure is not intended or offered for sale (Section CITY
7044, Business and Professions Code).
❑ OWNER •
I, as owner-of the property,•am exclusively contracting Ar. nd .MCS Robert Wh i tne. •
with licensed contractors to construct the project MAIL ' ;.
(Section 7044,Business and Professions Code). ADDRESS Wel land -'A t . B
CITY Temple e .Cit TEL.NO.444-0;x.•20, z 3-5 2,4 A
' CONSTRUCTION LENDING AGENCY P Y '
I hereby affirm'that there is a construction lending,agency # o'o' o 4.1
for th(e performance of..the-work for which this permit is CONTRACTOR E. L. PAYNE-COMPANY 4
issued Lender's Name 7,Civ C) ADDRESS a'.
-62.7.00
166 W. 'Li.ve•"•Oak Avenue i� _
Lender's AddressCITY Arcadia TEL.NO. 446-6118 I ° °'O'2 7.Q Q c�i
I certify that I have'.read this application and state that the STATE120228 LIC. C--201224-80
above information is correct.I agree to comply with all County LICENSE NO. CLASS
ordinanc and State laws regulating Heating,Ventilating and
Air C d• ioning,and h by authorize representatives of this SEE REVERSE FOR EXPLANATORY LANGUAGE
C u y o enter up the above-mentioned property for
in ion"pdrposes.
'12-18=80
Signature-of Per.' ittee Date _
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1403120034
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626.) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ITR: 10260 IT: 11 UN: .003 I I 5555 WELLAND AV 1
I FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802932 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18573-015-028 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY CAI
102 COMPRSR < 100 KBTU 2.00 COM 54.00 I I
1TENANT: 108 FURNACE/HEATER <100 2.00 UNI 54.00 (ISSUED ON: PROCESSED BY: PLAN BY:
TOTAL FEES 135.80 03/12/14 SR
(OWNER: TEL. NO: I (FINAL DATE FINAL BY: CODE: 1
II W00 HOWARD K;BIK FONG (323) 981-0165- I l L) 1
536 CASUDA CANYON 1
IMONTEREY PARK 91754 1 IDESCRIPTION OF WORK 1
1 IREPLACE EXISTING ROOF TOP PACKAGE SYSTEMS
(APPLICANT: TEL. NO: I I I
ILIU, NORMAN (626) 926-8477- 1
110932 GRAND AVENUE I ISPECIAL CONDITIONS:
TEMPLE CITY CA 91780 I I I
r
I I I
ICONTRACTOR: TEL. NO: I I�OV����DATE INSPECTOR SIGNATURE INSPECTOR SIGNATURE
INORMAN LIU SERVICE CORP (626) 579-1559- I 1-
110932 GRAND AVENUE LIC. NO I IFAU/WALL FURNACE I I I
ITEMPLE CITY, CA 91780 559374 I I I I I
ICOMBUSTION AIR OPENINGS I I I
(ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I I I
I - 1 I I I
LIC. NO: IAC/COMPRESSOR I I I
O ERY40STAT �I
I _
IFIRE DAMPERS
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ISMOKE DETECTION DEVICES I I I
1 II I I
I i 1COMNC:RCIAL HOOD
I i I I I I
1 I I I I I
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(REPORT ID: DPR264 ROUTE TO: BS0508 1