HomeMy Public PortalAbout10118 DAINES DR_Mechanical__ 7e"364E�&dBr13'-°i7' APPLICATION FOR PERMIT
o- HEATING - VENTILATING-= AIR'CONOITIONING
BUILDING AND SAFETY DIVISION
FO,R APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) - - ADDRESS ..
LOCALITY •�'
NO _,TYPEOFA'PPLIANCEOR EQUIPMENT FE,E NEAREST
CROSS ST:
ABSORPTION UNIT., BTU '
• .. - OWNER
AIR HANDLING UNIT, CFM MAIL
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Plan.check fee 25% of above:
PERMIT ISSUING FEE $ DD
TOTAL FEE U
PLAN CHECK•APPLICANT ,
NAME '
ADDRESS"
CITY �- TE-L-NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ.THIS APPLICATION
-AND STATE THAT.-THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANC ES`'AND LAWS REGULATING HEATING; VENTI-
LATING, AIR,CONDITIONING -
I HEREBY ,CaYAM NOT -ACTING IN VIOLATION APPROVALS .D T FINSPECTOR' SIGNATURE'OF CHAPTER 9 DBUSINESS AND PROFESSIONALCODE OF THE STA A ROUGH ����� •�- -
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R76 A364 - CE 818- 5-73
APPLICATION FOR PERMIT
'HEATING - VENTILATING - AIR CONDITIONING
- COUNTY OF LOS ANGELES IBUILDING ^^77��
DEPARTMENT OF COUNTY ENGINEER ADDRESS D es U�/�,
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN, OWNER
(PRINT OR TYPE ONLY)
NO TYPEOF•APPLIANCEOR EQUIPMENT FEE
ADDRESS
CITY TEL. No
ABSORPTION UNIT, BTU
a CONTRACTOR -
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
CITY e ep TEL. NO.
COMPRESSOR, BTU Om0 STATE LIC
LICENSE NO. ,� CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE, ESSED Br
EVAPORATIVE COOLER 057�
FURNACE: FAU GRAVITY— INSPECTION RECORD
FLOOR BTU
HEATER ' SUSPENDED UNIT, 10,
WALL
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Cl-
Plan
LPlan check fee•25% of above. See reverse. _
PERMIT ISSUING FEE S 3 00
TOTAL FEE Q
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY 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 DAT , INS�ErO 'S IGNATURE
LAT ING, AIR CONDITIONING
ROUGH
I
HER ?710=
VIOLATION _
OF•CHAP TER 9, FJSSIONAL FINAL
CODE'OF THE S
SIGNATURE PERMIT VALIDA N CK. M O CASH ,
OF PERMITT
PLAN CHECK ALIDATION CK. 0 CASH J
3' 5`,9'c T6f 441 U 1 5..1 v AJn
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1207300009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT-
LEGAL ID I FEES PAID I BUILDING ADDRESS
ITR 22438 LT 15 BL 001 1 1 10118 DAINES DR I
1 IFEE DESCRIPTION QUANTITY UOM AMOUNT 1 TEMP CA 917802705 I
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET - •1
18586-025-015 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY, Cl
1 102 COMPRSR < 100 KBTU 1 00 COM 27 00
(TENANT 108 FURNACE/HEATER <100 1 00 UNI 27 00 (ISSUED ON- PROCESSED BY- PLAN BY• 1
1 130 AIR INLETS/OUTLETS 4.00 UNI 17 60 107/30/12 SR I
1 154 NO PERMT $224 70 MIN 342 20 342 20 1 1
(OWNER TEL NO I TOTAL FEES 441 60 IFIN TE FINC;.BB)�% CODE 1
ISCHULAN, SHELLEY (626) 401-2907- 1 1"1
110118 DAINES DR I v
ITEMP 917802705 1 IDEtCRJPTION OF WORK 1
IREPL3?CE FURNACE, COIL, A/C CONDENSER, RE-VAMP DUCTS 1
I I I I
(APPLICANT TEL NO
IZABATTA HTG A/C (323) 627-3132- I I 1
IP 0 BOX 9368 1 (SPECIAL CONDITIONS I
(ALTA LOMA CA 91701
(CONTRACTOR TEL NO I IAPPI'3,AL DATE INSPE TOR SIGNATURE
IZABATTA HEATING AND AIR (909) 989-9200- I 1 I
IF 0 BOX 9368 LIC NO j - I FAU/.,iP.LL FURNACE
(ALTA LOMA, CA 91701 561159 C20 1 I_! N�
ICOM-STION AIR OPENINGS 1 1
(ARCHITECT OR ENGINEER TEL NO I IDUCT.r'ORK 1 I
- LIC NO j JAC/COMPRESSOR
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