HomeMy Public PortalAbout9167 FORTSON DR_Mechanical__ 76A364C
CE-818 (REV 11/78)
os ,APPLICATION FOR PERMIT '
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS N- -
(PRINT OR TYPE ONLY)
LOCALITY '
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST
ABSORPTION UNIT,BTU
OWNER �. m / �► _'
AIR HANDLING UNIT,CFM - MAIL
ADDRESS
BOILER,BTU CITY - TEL NO t
COMPRESSOR,BTU CONTRACTOR L.,V
VENTILATION SYSTEM. . ADDRESS
If
EVAPORATIVE COOLER CITYV TEL NO
FURNACE FAU ' GRAVITY STATE LIC -
FLOOR BTU LICENSE NO 13Z/ CLASS
HEATER SUSPENDED UNIT_ APPROVALS DATE
WALL" INSPECTOR'S SIGNATURE• '"�
ROUGH
CL
•. FINAL
INSPECTION RECORb
f�
O.
Plan check fee 25.% of above.
PERMIT ISSUING FEE$
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
ADDRESS .
CITY ' ' - - TEL NO _ 9.1 ,n1 2 f1 n
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND 7 7 '
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL #,O O 0;0 4. 1
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR '
CONDITIONING PERMIT'VALIDATION 2<O C 17.0'0
I HEREBY CERTIFY AT I AM NOT A NG IN VIOLATION -OF
CHAPTER 9. DIVISION 3, O THE.BUSINESS PROFESSIONAL.CODE '•o 0 0.,1 7,Q Q
OF THE STATE OF _ „ - i i
SIG ERM 1 ,022 —8O -
OFPERMITTEE '
DISTRICT NO �y^�,. PROC�ES/S/E/D BY � �
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0704060008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ITR: 14396 LT: 33 1 1 9167 FORTSON DR I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801323 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ENCINITA
I
15382-016-013 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: Jl LOCALITY: TEMPLE CITY, Cl
102 COMPRSR < 100 KBTU 1.00 COM 27.00 I I
(TENANT: 108 FURNACE/HEATER <100 1.00 UNI 27.00 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
I 130 AIR INLETS/OUTLETS 9.00 UNI 39.15 104/06/07 JK 10/03/07 1
I I TOTAL FEES 120.90 I I
(OWNER: TEL. NO: I _ - IFINAL L)ATE FINAL BY: CODE:
IERICKSON JOHN W;MARTY (626) 287-1779- 1 _ I 1
19167 FORTSON DR I1_ 1
ITEMP 917801323 1 IDESCRIPTI N OF WORK 1
I I 11NSTALL NEW A/C & HEATING SYSTEM
I
(APPLICANT: TEL. NO: I 1 I
ICONNOR AIR (626) 286-3157-
14931 N. ENCINITA AVE 1 ISPECIAL CONDITIONS: I
ITEMPLE CITY CA 91780 I I I
I I I I
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ICONNOR AIR CONDITIONING (626) 286-3157- 1 1 I
14931 ENCINITA AVE LIC. NO I IFAU/WALL FURNACE I 1 y V
ITEMPLE CITY, CA 91780 403735 C2O 1 I
1 1 1COM13USTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: - i IDUCT WORK
1 LIC. NO: IAC/COMPRESSOR I I I
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1 I ITHERMOSTAT
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I I IFIRE DAMPERS I 1
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IREPORT ID: DPR264 ROUTE TO: BS0508 1 I I I
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