HomeMy Public PortalAbout5020TEMPLE CITY BLVD_Mechanical (2) TaAse�E iF,E�egeAl >m ` „ APPLICATION FOR PERMIT
` NEATINGC�ING - AIR CO ITjO INC
• ` - •
COUNTY LOS A ELZer
DEPARTME FCOUNTY ENGINEER
BUILDIN NO SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING 11
(PRINT OR TYPE ONLY) ADDRESS 'GM
LOCALITY C
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER �� C.
AIR HANDLING UNIT CFM MAIL
ADDRESS
BOILER BTU CITY TEL NO
f
COMPRESSOR BTU sf1
CONTRACTOR
VENTI LATION SYSTEM ADDRESS p �LNV� A
EVAPORATIVE COOLER CRY J� TEL NO l /�(„
FURNACE FAU GR VITY / STATE LIG
FLOOR BTU LICENSE NO �� CLASS "'
HEATER SUSPENDED UNIT— DISTRICT NO j/J GB UP :ONE PROLES DBY
WALL /�Di R_I
INSPECTION RECORD
Plan check fee 25% of above
PERMIT ISSUING FEE$
TOTALFEE
JLAN CHECK APPLICANT '
NAME
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND _
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGUUTING HEATING VENTILATING AIR ` x
CONDITIONING
I HEREBY CERTIF THAT I AM NOT ACTING II VI LATION OF APPROVAS ID_ :`INSPE To IGNATDA
CHAPTER 9 DIVISI OF THE BDSINESS AND
PR ES OVAL CODE ROUGH
OF THE STATE OF RNIA
SIGNATID ��f.� FINAL _
OF PERMITTE
PLAN CHECK VALIDATION CK Mo CASH PERMIT VALIDA IOIV��D CASH
2 4 2 i'JUN 28 4 1 0 2 ?.0 O AS.