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APPLICATION FOR P MIT
HEATING VENTILATING AICONDITIONING
COUNTY OF LOS ANGELES g01DR ISS
DEPARTMENT OF COUNTY ENGINEER 63-73–N—Enc.in,i_ta–Ave..
BUILDING AND SAFETY DIVISION LOCALITY ,,,,�7
Ce e_C_it.y License 0093
NEAREST
CROSS ST. O 1 I Ve
FOR APPLICANT TO FILL IN OWNER u',.
(PRINT OR TYPE ONLY) 1[ti_n_ OIC.i+i�Lvl
No. TYPE&SIZE OF EQUIPMENT FEE ADDRESS 6373 N. Enc i n i to Ave.
SEE BACK OF APPLICATION
FORCE AIR FURNACE, BTU -1-00.,A0 1 OO CITY Temple City TEL. NO.2II7_4253
CONTRACTOR E..—L..—Paryne Company
1
COMPRESSOR, BTU _ $}OQ ADDRESS
166 W. Live Oak
VENTILATION FAN
CITY Arcadia pATE TEL. NO. (}LI 6 11$
LIST ALL OTHERS BELOW L-ICENSE NO. 120228 COAL O 0
CISTRICT NOR. "UUH DZONE RO EB _O BY
INSPECTION RECO D
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.Plan check fee. See reverse. ?
I'P:1011'I" ISMANG HJ: S 'o
]wI'A I, FE -i 2I 00
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 ALLOROI NANCES AND LAWS REGULATING HEATING. VENTI- APPROVALS DATE INSPE TOR'S SIGNATU
LATING. AIR CONDITIONING.
ROUGH
HEflEBY CERTIFY TH AM NOT ACTING IN VIV_ ION
OF CHAPTER 9. DIVISION O THE BUSINESS ANO P OF ONAL FINAL '"
I
COON OF THE STATE 0 //
FERMI
E URE (/b/yam Q PERMIT VALID
OF CK. M.D. CASH
LayRMIT
P 11IVOR RSLiBROOENK AffON`AS" I
1906� 0.412d:1 0 27,00ms
P ICY HOLDER-
POLICY NUMBE : 2 3/ 07fO 4J 7