HomeMy Public PortalAbout5835TEMPLE CITY BLVD_Mechanical (2) 76 A364- CE 618-1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING C^ /
DEPARTMENT OF COUNTY ENGINEER ADDRESS J
C�� L
BUILDING AND SAFETY DIVISION LOOALITY
NEAREST
'.CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) as t
NO. TYPE&SIZE OF EQUIPMENT MAIL
FEE ADDRESS
SEE • K OF ge ,PL ATION
CITY TEL. NO.
FORCE AIR NACE, BT
CONTRACTOR
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN CITY e TEL. NO.
LIST ALL OTHERS BELOW STATE• " V` C./'8 � � LTC.C.
LICENSE NO. CLASS (2 t
�
DISTRICT NO. GROUP ZO
INSPECTION REC •R
IULOrOS
- /
' U
LLA
Plan check fee. See reverse. z
1'I:H111'I' Itis[-I\G FN:i; S
TOTAL Fl-'Ii:
PLAN CHECK'APPLICANT
NAME
ADDRESS
A
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I �.
AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- AFP
LATING.AIR CONDITIONING. R&ALSIAJ DATE ,,.,illfs PECTOR'S SIGNATURE
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION ROUGH /'w
OF CHAPTER 9, DIVISIO OF THE BUSINESS AND PROFESSIONAL .:FINAL
CODE OF THE STATE O CA IFOR NIA.
�OLFPERMITTEE
TURE PERMIT VALIDATION CK. M.O. CASH
PLAN CHECOVALIDATION 9V M.O. CASH
J. 7 6 -JAN 17 41 9.5 0 ,3