HomeMy Public PortalAbout9420 DAINES DR_Mechanical__ 364 - cE6,18 -x9
Q-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKIN"S,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT'TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL. NO.
CONTRACTOR
AIR HANDLING UNIT, CFM I ooli
ADDRESS
BOILER, HORSEPOWER _
CIT TEL.
` COMPRESSOR, HORSEPOWER_ L)d STATE LIC.
/ LICENSE NO. / CLASS o��✓
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER !� �( te
FURNACE: FAU GRAVITY
FLOOR BTU INS• ECTION RECORD
HEATER: SUSPENDED UNIT
WALL c`l�+Ci '
z_
NEW. ADDITION_ PERMIT $ 3 00
ALTER REPAIR_ TOTAL FEE $ zz
r .
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
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 INSP �TOR'S SIGNATURE
LATING, AIR CONDITIONING. ! -
I HEREBY CERTIFY THAT" I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE CALI RN IA.
SIGNATURE JACK R. ALLEN, SUPERVI G MECHANICAL ENG'R.
OF PERMITTEE �/ [[ ,
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
CV
`-EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ... (/%'I�✓
_ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1312100012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID BUILDING ADDRESS:
ON FILE 9420 DAINES DR 1
' IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917803112
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18588-028-001 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI
I 108 FURNACE/HEATER <100 1.00 UNI 27.00 I I
(TENANT: I TOTAL FEES 54.80 (ISSUED ON: PROCESSED BY: PLAN BY: 1
112/10/13 SR 1
(OWNER: TEL. NO: I ITE FI Y: CODE: I
IMC NEVIN THEODORE J;MARY N (626) 353-5325- I F _r
19420 DAINES DR I I �` I
ITEMP 917803112 I (DESCRIPTION OF WORK 1
I IREPLACE EXISTING FURNACE IN ATTIC I
(APPLICANT: TEL. NO: i I
ICONTRERAS, CARRA (626) 286-3157-
14931 N ENCINITA AVE j ISPECiAL CONDITIONS: `
TEMPLE CITY CA 91780
CONTRACTOR: TEL. NO: 'A S DATE I IN PECTOR SIGNATUR
ICONNOR AIR CONDITIONING (626) 286-3157- I
14931 N ENCINITA AVE LIC. NO I IFAU/`WALL FURNACE I
ITEMPLE CITY CA 91780-3706 403735 I 1
ICOMBUSTION AIR OPENINGS
I I I I I
(ARCHITECT OR ENGINEER: TEL. NO: JDUCT,WORK I
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LIC. NO: I IAC/COMPRESSOR
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IREPORT ID: DPR264 ROUTE TO: BSO508 I I I
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