HomeMy Public PortalAbout9483 BLACKLEY ST_Mechanical__ 76 A364,.-,CE 818- 5-73[1
APPLICATI FOR PERMIT
1. HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS 48 Blackley St.
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITYTemple City
NEAREST
CROSS ST. Cloverl
FOR APPLICANT TO FILL IN OWNER Thompson
(PRINT OR TYPE ONLY) MAI L
ADDRESS 9� $3 Blackley St
NO TYPE OFAPPLIANCE OR EQUIPMENT FEE '
CITY Temple City TEL. NO. 286 4. 01
ABSORPTION UNIT, BTU
CONTRACTOR
Valley He-atin Co
AIR HANDLING UNIT, CFM ADDRESS 1116 S San Gabriel Blvd. •-
BOILER, BTU CITYSan Gabriel TEL. NO, 28 818
1 COMPRESSOR, BTU __1T__1_000 STATE LIC
LICENSE N01 8 CLASS C 20
VENTILATION SYSTEM DISTRICT NOGROUP /IL NE PRO ESSED BY
EVAPORATIVE COOLER `(/,\/ r
1 FURNACE: FAU X GR V TY INSPECTION RECORD
FLOOR BTU
HEATER. SUSPENDED-UNIT-
WALL
USPENDED UNIT_WALL
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Plan check fee 250 of above. See reverse.
PEWMIT ISSUING FEE S
TOTAL FEE (3
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
i
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP ICATI ON '
AND STATE THAT THE ABOVE IS CORRECT AND AG MPLY ,
WITH BALL ORDINANCES AND'-LAWS REGULATIN HEATING, ITI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING -
' ROUGH
I HEREBY CERTIFY TH I AM NO ACTING IN VI ION '
OF CHAPTER 9, DIVISIO OF THE BU NESS AND PROFE NAL FINAL �
CODE OF THE STATE 0 C IFORNIA -
SIGNATURE PERMIT VALIDATION CK. M 0. CASH
OF PERMITTEE
PLAN.CHECK ALIDATION CK M O CASH
1 3'Or-SEP 29 4,x1 0- 1 9.5 0
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76A364C
CE-818 (REV_ 11/78)
O, APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY,OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ,
NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT.CFM MAIL
ADDRESS
BOILER,BTU CITY TEL NO ,
I •
COMPRESSOR.BTU CONTRACTO -
VENTILATION SYSTEM ADDRES
EVAPORATIVE COOLER CITY 9O� EL
FURNACE FAU ' GRAVITY STATE LIC �y
FLOOR BTU LICENSE NO CLASS
HEATER SUSPENDED UNIT_ APPROVALS DATE INSPECTOR S SIGNATURE '
WALL
ROUGH �r
FINAL
171-710 V
INSPE TION RECORD
O
Plan check-fee 25% of above o.
N
4 PERMIT ISSUING FEE$ z
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME '
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND O� R ,
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL - fl'7 A
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR
CONDITIONING PERMIT VALIDATION # o 0 0�0 4
I HEREBY,CERTIFY THAT•I AM NOT ACTING IN VIOLATION OF*
CHAPTER Z 9, DIVISION 3, O THE B SINESS AND PR FES CODE - 2 o O 1 .A O O
OF THE STATE OF IA
.SIGNATURE O O O 1 3'00X'.V
OF PERM ITTE "L' L `
DISTRICT NO PROCESSED BY O.6 ,V. --80