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APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL INBUILDING
(PRINT OR TYPE ONLY) ADDRESS 9920 .E. Broadway
LOCALITY Temple City
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSSET.
ABSORPTION UNIT.BTU
OWNER Walter F. Diener
AIR HANDLING UNIT.CFM AMAIL DDRESS 9920 E. Broadway,
BOILER.BTU CITY Temple City TEL.NO. 286-651
1 COMPRESSOR.BTU 3-1/2 ton 1C OO CONTRACTOR
Bryant Heat. & Air Cond
VENTILATION SYSTEM ADDRESS 1350 E. Las Tunas Drive
EVAPORATIVE COOLER CITY TEL.NO. -
San Gabriele 286-114
FURNACE: FAU_GRgVnYro� LO OO LCAENSE, 2217`)1 CLASS C20
1 FLOOR BTU II 1111
HEATER: SUSPENDED—UNIT— APPROVALS DATE INSPECTOR'5 SIGNATURE
WALL
ROUGH-
FINAL
OUGH FINAL .3nlruc L– O
INSP TION'RECORD V
Cd
Ta' call: raa, *-'NS pilvT7,IN U�rno .(. O
Plan check fee 25% of above. - ady 9
PERMIT ISSUING FEE; 7 FP�LAN
TOTAL FEE 2 PLAN CHECK APPLICANTCK VALIDATNAMEADDRESS
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, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION 1 26162 A
HEREj0F ,.ORN1
Y THAT I AM NOT AC pf G IN VIOLATION OF
CHAPTER 9. OF THE BU51NE5 N PROFESSIONAL CODE # e ee'a•[I 1
OF THE STATASIGNATURE 2.e * 27.00
OFPERMITTL
DISTRICT NO. PR OC 0 ye.o o•2 7.0 Q'U
�J
0 0 8 1 '57!7 9