HomeMy Public PortalAbout5910 TEMPLE CITY BLVD_Mechanical (2) 76 A364 ,. CE 818 - 9-71
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4F, APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS .��1®�%ri'/1IF�L!'+ C(T3C frD
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITYMMP1W OiT-1,
NEAREST
CROSS ST. 1-4& M W A S
FOR APPLICANT TO FILL IN OWNER °
(PRINT OR TYPE ONLY) /1I fH3/WfTt I A✓IC* J.P OiA10941f
MAIL - '7 EaLA(r E CiT
NO. TYPEOFAPPLIANCE OR EQUIPMENT FEE ADDRESS 10 Y 8a°Ja
ABSORPTION UNIT, BTU CITY I-em ACS:G TEL. NO..2 86 6 q Q
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROC ED BY
EVAPORATIVE COOLER
FURNACE: FAU_GRAVITYo
FLOOR BTU INSPECTION RECOR cCd�
HEATER: SUSPENDED UNITo
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WALL � �� .77 t3
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Plan check fee 25% of above.. See reverse.
PERMIT ISSUING FEE S
TOTAL FEE oZ
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
L
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
H ALL ORDINANCES AND LAWS REGULATING. HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
INS, AIR CONDITIONING.
ROUGH
1HEREBY CERTIFY•THAT I AM NOT ACTING IN VIOLATION CHAPTER 9, DIVISION 3, OF THE BU NESS AND PROFESSIONAL FINALE OF THE STATE OF CA1J F0 NINATURE ( . � PERMIT VALIDATION CASH
PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH
.7�7.$S�SPR 1:9 44— •• 1. x..0.0 ♦S8
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE