HomeMy Public PortalAbout9302 BLACKLEY ST_Mechanical__ 76A364C
CE-818 (REV 11/78)
®, APPL ATION FOR P IT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
LOCALIT J
NO TYPE OF APPLIANCE OR EQUIPMENT FEE _
NEAREST
CROSS ST
ABSORPTION UNIT BTU +
OWNE
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AIR HANDLING UNIT CFM MAIL I
ADDRES
BOILER BTU CIT � P TEL NO
COMPRESSOR BTU CONTRACTOR
V i 7
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITY A TEL N
FURNACE FAU GRAVITY STATE -) LIC
FLOOR BTU LICENSE NO SLe CLAS
HEATER SUSPENDED UNIT_ APPROVALS DATE IN&IPSSIGNATURE
WALL
ROUGH -I'
FINAL 0
/V� w � N110
ION RE6AA15, cg
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Plan check fee 25% of above f
PERMIT ISSUING FEE$ V Z
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME - ,;�
ADDRESS 3�6 -7/
CITY TEL NO —4 6'6 9.0 A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL # O o o o 4 1
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR
CONDITIONING PERMIT VALIDATION ,2,o - 27.00
1 HEREBY CERTIFRRNI NOT ACTIN IN VIOLATION OF
CHAPTER 9 DIVISION SI ESS AN ROFESSIONAL CODE l0 0 0 2.7, 0 U ,
OF THE STATE OF CALIF ,
SIGNATURE
OF PERM ITTEE O 9, 'I 1 �7/ 9
DISTRICT NO CESS BY
J, Ud .
76A364-CES18 -1/70 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FNEA
RESS 9302 � f'' P
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LITY Temple City
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGESTS ST
FOR APPLICANT TO FILL IN OWNERJohn Sells
(PRINT OR TYPE ONLY) MAIL
NOS TYPE OFAPPLIANCEOR EQUIPMENT FEE
ADDRESS202 Bella Vista Dive
ABSORPTION SYSTEM, BTU CITY Arcadikag TEL NO 445-2772
CONTRACTOR J & J Htg & A/C Serv.Cor
AIR HANDLING UNIT, CFM
ADDRESS 2379 First St . ,
BOILER, HORSEPOWER CITY La Verne, TEL NO 339-6011
COMPRESSOR, HORSEPOWER STATE LICENSE NO. 261695 CLASS C 2 0
VENTILATION SYSTEM DISTRICT NO CLASS GROUPZONE PROCESSED BY
EVAPORATIVE COOLER �_'Qf Rel e
1 FURNACE FAU ITY INSPECTI,ON RECORD
FLOOR BTU 5.00
HEATER SUSPENDED-UNIT-
WALL
USPENDED UNIT_WALL
d
O
U
w
O
U
W
f/7
NEW-ADDITION- PERMIT $ 3 00 Z
ALTER-REPAIR- TOTAL FEE $ 8.00
PLAN CHECK APPLICANT U
NAME
ADDRESS
Cl TY TEL NO
I HEREBY 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, AIR CONDITIONING
' ROUGH
IHEREBY CERTIFY THAT I AM NO A TING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUS[ S NO PROFESSIONAL FINAL
CODE OF THE STATE ALIFOR
SIGNATUREI JACK R. ALLEN,SUPERVISIN HANICAL ENG'R
OF PERMITTEE, �.
PERMIT VALIDATION cK CM'O CASH
PLAN CHECK VALIDA ON
(' o-,4;3 1'3 WR 29 4 1 D 8,00cli
It
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE