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COUNTYLO NGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FO APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) - ADDRESS 5430 N_ARDEN_DR..
LOCALITY TEPP-4E CITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
- CROSS ST.
ABSORPTION UNIT,BTU
OWNER ." SPRINGER,_KOREN-E
AIR HANDLING UNIT,CFM MAIL
ADDRESS SAME
BOILER,BTU CITY TEMPLE CITY TEL.NO. 444-9657
1 COMPRESSOR,BTU 3-H.P 7 50 CONTRACTOR TRANE HCC
VENTILATION SYSTEM ADDRESS 2034 N. PECK- RD.
EVAPORATIVE COOLER CITY S0, EL MONTE TEL.NO. 579-7982
1 FURNACE: FAU_ GRAVITY 7 50 L TE LIC.
CAENSE NO. 265094 CLASS
FLOOR BTU —1.0.0-,-000-
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ONE CESSED BY
WALL (�C`-I
'6^ag hUO
INSPECTION RECORD 9L
V
a
Plan check fee 25% of above.
PERRAIT ISSUING FEE$ 4 50 Z
4®VAd FEE 19.50
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY - TEL.NO.
IHEREBY 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, VENTILATING, AIR
CONDITIONING. -
I HEREBY CERTIFY THAT IAM NOT ACTING IN VIOLATION OF APPROVALS - 'DATE INSPECTOR'S
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CALIFORNIA. ROUGH
SIGNATURE FINAL
OF PERMITTEF
PN CAECK VALIDATION CK. M.O. CASH PERRflIT!/ALIDATION cK. M.O. CASH
LA
y 2 9 O'C'IdOV 23 4,,l D 1 C.5 U r s
PO1UCY HUMBERoi