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76A364 - CEBIB - 3 69 II
_ APPLICATION FOR PERMIT «»
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FNEAREST
LDING
DEPARTMENT OF COUNTY ENGINEER RESS 4832 Alessandro
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER ALITY Tem le Cit
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGSS ST
FOR APPLICANT TO FILL IN OWNER Frank Klavon
(PRINT OR TYPE ONLY)
MAIL 4832 Alessandro
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
1 ABSORPTION SYSTEM BTU 36.000 5 00 CITY Temple City TEL NO 286-6392
AIR HANDLING UNIT CFM CONTRACTOR Bryant Heat & Air Cond Inc
ADDRESS 1350 E Las Tunas Drive
BOILER HORSEPOWER
CITY San Gabriel TEL NO 286-1141
COMPRESSOR HORSEPOWER STATE LIC
LICENSE NO 221751 CLASS C-20
VENTILATION SYSTEM DISTRICT NO
GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER ✓ D Y T
1 FURNACE FAU GRAVITY
FLOOR aTU 100_,000 5 00 I INSPECTION RECORD
HEATER SUSPENDED UNIT ?
WALL a
Q
U
Cie
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U
LU
CL
N
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NEW—ADDITION— PERMIT $ 3 00
ALTER--REPAIR_ TOTAL FEE ,$ 13 00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI APPROVALS DATE INSPECTOR S SIGNATURE
LATING Al NDITIONING
I HEREBI C R FY T A I AM NOT T 11
1IN VIOLATION OF ROUGH
APT
CHER SIO OF THE BUSI AND PROFESSIONAL FINAL L r
CODE OF T T LIFO IA
SIG JACK R ALLEN SU ERVISING CHANICAL ENG R
OF PER TT
PERMIT VALIDAT C M 0 CASH
PLAN ECK V L DATION
d0rBA '/V/ LI jo 4 S 1 6C-13 At R c-3 4 1 D 300-
BACK
CK OF APPLICATION FOR COMPLETE FEE SCHEDULE