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HomeMy Public PortalAbout5910TEMPLE CITY BLVD_Mechanical (2) 76 A364 ,. CE 818 - 9-71 TTY 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 _ _ WALL � �� .77 t3 W eqw ° z 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