HomeMy Public PortalAbout5561 WELLAND AVE_Mechanical__ • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1110310004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I
ITR: 10260 IT: 10 BUILDING ADDRESS: I
FEES PAID
1 5561 WELLAND AV 1
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 TEMP CA 917802962 I
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET:
18573-015-011 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
103 COMPRSR 101 500 KBTU 5.00 COM 261.20 1 I
TENANT: 109 FURNACE 101 500 XBTU 5.00 UNI 261.20 (ISSUED ON: PROCESSED BY: PLAN BY: I
1 1 TOTAL FEES 550.20 110/31/11 SR I
TOWNER: TEL. NO: 1IFINAL DATE FIN CODE:
I
1LAY, EMILY (626) 319-1750-
1 1 111--7 L/ I
JIMCRIPtIONFOF WORK
1 1 IROOF-TOP HVAC SINGLE PACKAGE UNITS REPLACEMENT 1
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1APPLICANT: TEL. NO: I I 1
IPOON, KAN CHING (626) 674-5331-
11412 1/2 DATE AVE. i ISPECIAL CONDITIONS:
1ALHAMERA, CA 91803 I _
II I
1CONTRACTOR: TEL. N0: I (APPROVALS DATE � INSPECTOR SIGNATURE
IKC HVAC SERVICE (626) 674-5331- I
11412 1/2 S DATE AVELIC. NO I IFAU/WALL FURNACE 1 I 1
1ALHAMERA CA 91803 797430C20 * 1
1 1 ICOMEUSTION AIR OPENINGS I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1IDIICT WORK I I I
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1 LIC. NO: I IAC/COMPRESSOR I I I
I1 1
I 1THERMOSTAT
1 1 IFIRE DAMPERS I I I
1 ISMOKE DETECTION DEVICES I I I
1 ICOMMERCIAL HOOD I I I
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1 1 I
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1 1 1 I I I
1 I I I
I* ADDITIONAL DATA ON FILE
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1 1RfiPORT ID: DPR264 ROUTE TO: BS0508
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Worrtificate
OMPENSATION DECLARATION ' APPLICATION FOR PERMIT
II have a certificate of consent to 'self
insure, of Workers'Compensation Irtsurance, HEATING - VENTILATING - AIR CONDITIONING
�or�a certified copy there (Sec. 38I0�0, Lob. Com)A t� CE-81 C
Po Icl—y—IV�ompany`v%�t+'y�+ld1� CE-818(REV. 10/81)
❑ Certified copy is hereby furnished. COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certifie copy is filed wit a count it i inspec FOR APPLICANT TO FILL IN BUILDING
ti n de artment. (PRINT OR TYPE ONLY) ADDRESS �p e.�J
I 1 gG7 LOCALITY
Date APpli
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CERTIFICATE OF EXEMPTION OM W KERS' NEAREST �\
COMPENSATION INSU CROSS ST.
(This section need not be completed if the work Involved by ABSORPTION UNIT, BTU DISTRICT NO. f/ PROCESSED BY
the permit is for one hundred dollars($100)or less.) (/{/
I certify that in the performance of the work for which this AIR HANDLING UNIT,CFM t
permit is issued,I shall not employ any person in any manner BOILER,BTU
so as to become subject to the Workers'Compensation-Laws. APPROVALS DATE INSP TOR' IGNAT RE
Date Applicant COMPRESSOR,BTU 2 ao0 �� 62 h ROUGH
NOTICE TO APPLICANT: If, after making this Certificate of VENTILATION SYSTEM FINAL -�
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- EVAPORATIVE COOLER VALIDATION
with comply with such provisions or this permit shall be r
deemed revoked. FURNACE: FAU GRAVITY /l a I►
LICENSED CONTRACTORS DECLARATION J FLOOR BTU fie_ (! o
I hereby affirm that I am licensed under provisions of Chapter 9 HEATER: SUSPENDED UNIT
'(commencing with Section 7000) of Division 3 of the Business WALL
and Professions Code,and my license is in full force and effect. 9L
Licens mb i Class `-0 V
Con ct r O
❑ I am ex mpt u der Sec. Sum
plol
B.&P.C. for s reason Plan check fee
PERMIT ISSUING FEE$ Q ;22933A
Date: '
Signature TOTAL FEE 6-0 #.o'o 0 0 0 8
OWNER-BUILDER DECLARATION PLAN CHECK APPLICANT I °1 1 G 5 0
I hereby affirm that I am exempt from the Contractor's License _
Law for the following reason (Section 7031.5, Business and NAME o 0 1 1 G 5 Q ,
U
Professions Code):
❑ 1, as owner of the property, or my employees with ADDRESS Q 9. 17-85
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section CITY TEL. NO.
7044, Business and Professions Code).
OWNER t
❑. I, as owner of the property, am exclusively contracting p f f
with licensed contractors to construct the project (Sec- MAIL
ADDRESS Q V1—�L.+ \11h,tion 70,44, Business and Professions Code).
CONSTRUCTION LENDING AGENCY CITY
I hereby affirm 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 � �rvJV�
Lender's Name w�' `
CITYQbQ tt�q TEL. NO. 1 bt 1
Lender's Address
I certifythat I have read this application and state that the STATE - LIC. C Z0
pp LICENSE NO. 2 CLASS
above information is correct. I agree t mply with all County
rdinances and ate laws relatin to uilding construction,
d her
a o ze r present es this County to enter
abo - d pr a f®in I ct' oses. SEE REVERSE FOR EXPLANATORY LANGUAGE
—i
atu og f Appl or Agent Date