HomeMy Public PortalAbout4912TEMPLE CITY BLVD_Mechanical (2) 76A E(CE 018A) o/TT APPLICATION FOR PERMIT
IREATINt - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDINGADDRESS 1.2 / wl � vp
(PRINT OR TYPE ONLY( 7 P�.E C
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT _FEE
NEAREST y
CROSS ST S /l
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS
BOILER BTU CITY/�
COMPRESSOR BTU3C�ODO �ENj / IL C
/T, TEL NOayg�_ boy
/ So CONTRACTOR .f14 /l• EA7/N /
VENTILATION SYSTEM ADDRESS a2 u a R
EVAPORATIVE COOLER CITY (4 Re7 T L NO
FURNACE FAU_GRAVITY STATE LIC
FLOOR 'BTU LICENSE NO -.20 31 98 CLASS vv
S O
HEATER SUSPENDED-UNIT DISTRICTNO GROUPTOME PR Ce55eO Rv
WALL
INSPECTION RECORD
Plan check fee 25% of above i
PERMIT ISSUING FEE$ S-0 =
TOTAL FEE Q
PLAN CHECK APPLICANT
NAME X0,Mer E. ,BRaoK
ADDRESS'96 N,
CITY/g,;?"Sq 70a TEL NO 33'/-87/
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 VENTILATING AIR
CONDITIONING '
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR S SIGNATURE
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CAL( NIA /O ROUGH
SIGNATURE `_ FINAL
OFPERMITTEE
PLAN CHECK VALIDATION CA u0 CASH PERMIT VALIDATION cK mo cesH
7 41 u 1 9.506s