HomeMy Public PortalAbout5020TEMPLE CITY BLVD_Mechanical �BIB(REV 11/78)
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VVPA ION FORHEATING TING - DITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL INTADDRESS
DING �^f
(PRINT OR TYPE ONLY) Q Ot O Q Lvo
ALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FE
RESSSST
ABSORPTION UNIT 8TU ER VSAIR HANDLING UNIT CFM //��RESS /D
BOILER BTU CITY �.� a TEL NO
COMPRESSOR BTU fly I CONTRACTOR
VENTILATION SYSTEM /Y N
ADDRESS �u(// v, w(.9` �✓V
EVAPORATIVE COOLER CITY �f- TEL NO GY-.q
/ FURNACE FAU_GRAVITY STATE l`' LIC
FLOOR BTU O LICENSE NO ` -&TU CLASS
HEATER SUSPENDED—UNIT— APPROVALS DATE INSPECTOR S SIGNATURE
WALL
ROUGH y
d
FINAL - V
INSPECTION RECORD a
O
Plan check fee 25% of above
PERMIT ISSUING FEE;
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL NO 2 0 4 3 5 A
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND II
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH AU-
ORDINANCES
•I. 4 1
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR
CONDITIONING OF PERMIT VALIDATION 2 2;7 0 0
CHAPTERS 9EBY DIV SEON 3 TF THE BUSINESSRTIFY THAT I AM NOT ANO CTING IFESS ONALOCODE • • • 2-/. 0 0 6
OF THE STATE OF CAU NIA
SIGNATURE 0 ,52V-80
OF PERM ITTEE
DISTRICT NO PROCESSED
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