HomeMy Public PortalAbout9842 WENDON ST_Mechanical__ 76A364 - CE818 - 3-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES fNEAR7EST
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DEPARTMENT OF COUNTY ENGINEER 7la
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER ,1 1019
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING _ �//_ L ry LS
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY `TEL. NO.. �j
CONTRACTOR I Cly �/ /7' 10
AIR HANDLING UNIT, CFM
BOILER, HORSEPOWER ADDRESS /
COMPRESSOR, HORSEPOWER eLI
LICE S N0. CLA�
VENTILATION SYSTEM DISTRICT N0. GROUP ZONE ES5ED BY
EVAPORATIVE COOLER ��
FURNACE: FAU GRAVITY
FLOOR BTU INSPECTWN RECO
HEATER: SUSPENDED UNIT70
WALL d ^
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NEW—ADD IT10N_ PERMIT $ 3 00 % Z
ALTE 21L
EPAIR_ TOTAL FEE $ 001Z� C/L"r
PLAN CHECK APPLICANT 42
NAM
ADDRES � /
I HERE CKNOWLED.GE T T I HAVE READ THIS APPLICATION
AND STA THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI- APPROVALS DATE INSPEC R'S SIGNATURE
LATING, AIR CONDITIONING.
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3, OF THE BUSIN AND PROF ZONAL FINAL
CODE OF THE STATE OF CALIF RN IA.
SIGNATURE _ JACK R. ALLE , SUP RV MECHANICAL ENG'R. i
OF PERMIT T ,
PERMIT VALIDATION CK. M.O. CASH -
PLAN CHECK VALIDATION
Fl-) 3 2 011 LI-Ec 31 a 1 D 7.00co
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
" WORKER'S COMPENSATION DECLARATION 20-0048 DPW seas LIME GREEN
I hereby affirm that I have a certificate of consent to self insure, 76A364C APPLICATION FOR PERMIT
or a certificate of Worker's Compensation Insurance,or a certified HEATING-VENTILATING-AIR CONDITIONING
copy there.-yec.3800 Lab.C.)
Po(bpNS1-4 7 9 7 0 2 Company Fremont COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV.
❑ Certified copy is hereby furnished.
® Certified copy is filed with the count building inspection FOR APPLICANT TO FILL IN BUILDING
department. Y g p (PRINT OR TYPE ONLY) ADDRESS 9842 Wendon Ave.
Date 4-16-92 Applicant AAA Cond Air LOCALITY NO. TYPE OF APPLIANCE OR EQUIPMENT FEE Templg- City
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST.
Goldenwest
COMPENSATION INSURANCE
ABSORPTION UNIT,BTU ASSESSOR
(This section need not be completed If the work involved by the MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) AIR HANDLING UNIT,CFM
DISTRICT NO. PROCESSED BY
I certify that in the performance of the work for which this permit
is Issued, I shall not employ any person in any manner so as to BOILER,BTU D Q
become subject to the Workers'Compensation Laws. O
COMPRESSOR,BTU 48,00Q_
APPROVALS DATE INSPECTOR'S SIGNATURE
Date Applicant VENTILATION SYSTEM
NOTICE TO APPLICANT: If, after making this Certificate of ROUGH
Exemption,you should become subject to the Workers'Compensation EVAPORATIVE COOLER
provisions of the Labor Code,you must forthwith comply with such FINAL C�
provisions or this permit shall be deemed revoked. FURNACE: FAUX GRAVITY
LICENSED CONTRACTORS DECLARATION 1 FLOOR BTU zj�1 Cid VALIDATION
I hereby affirm that I am licensed under provisions of Chapter 9 SUSPENDED UNIT
(commencing with Section 7000)of Division 3 of the Business and HEATER: WALL
Professions Code,and my license is In full force and effect.
bT7
License Number 2 9 3 5 2 9 Lic.Class C 2 0
}
CL
AAA Cond Air 9-30-92
Contractor Date C
❑ I am exempt under Sec. Plan check fee f7d bO Q
B.&P.C.for this reason PERMIT ISSUING FEE$ 6-0 C
I-
Date TOTAL FEE o U.
Signature a
PLAN CHECK APPLICANT V
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law NAME
for the following reason(Section 7031.5, Business and Professions
Cotre): ADDRESS •- , x
� _•i .8
I, as owner of the property, or my employees with wages ;i "
as their sole compensation, will do the work and the CITY TEL.NO. . ,O
structure is not intended or offered for sale(Section 7044, 1 1TENS
Business and Professions Code). OWNER Freitagr-t,n—�,
r_1 1, as owner of the property, am exclusively contracting MAIL I 0 i k 6 1 o 0101
with licensed contractors to construct the project (Sec- ADDRESS 9842 Wendon Ave. ti•
=•�LC ^n• ;r 1.[C'.tion 7044,Business and Professions Code). �
CONSTRUCTION LENDING AGENCY
CITY Tem 1e Cit TEL NO 443-9411 ••RANGE
°.
I hereby affirm that there is a construction lending agency for CONTRACTOR
the performance of the work for which this permit Is issued AAA Conditioned Air
(Sec.3097,Civ.C.). _
ADDRESS 10160 Valley Blvd rjtl IL!-:=_I:li t�� Jf _
Lender's Name CITY El Monte TEL.NO. 579-1800
?y?� y;F '�o 57
Lender's Address
I certify that I have read this application and state that the above CENSE NO. 293529 LIC.
C 2 0
information is correct. I agree to comply with all County ordinances
and State laws relating to building construction,and hereby authorize
rep resen�'l
of this C unty o enter upon the above-mentioned
propertyn do uo s SEE REVERSE FOR EXPLANATORY LANGUAGE
Daid Cross 6-3-91
SIGNATURE OF APPLICANT OR AGENT DATE