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APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN TADDRESIS
LDING
(PRINT OR TYPE ONLY)
ALnY
NO. PE OF APPLI NC EQUIPMENT FEE
RI�ST
SS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNPT,CFM MAIL
ADDRESS
BOILER,BTU CnYTEL N
BM
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER C TEL N
FURNACE: FAU GRAVrT-Y STA UC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED' UNIT_ AP PRayALS DATE IXSPECTOR'S SIGNATURE
WAI I
ROUGH
FINAL O
INSPECTION RECORD U
Plan check fee 25% of above.
PERMIT ISSUING FEE$
TOTAL FEE
PLAN'CHECK APP ANT - PLAN CHECK VALIDATION
NAME CiO. I'yL,LL.LCOL--�
ADORE
TEL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THLS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ` 2 4 7 55 A
ORDINANCES AND LAWS REGULATING HEATING. VENTILATING, AIR
CONDITIONING. PERMIT V I N`` # o o a o 4 1
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATIOry OF U '
CHAPTER fl, D 3, 0 THE BUSINESS AND PROFESSIONAL BODE I 2.a a 2'7 O O
OF THE ST O I'
61a NATURE I IO 0 0 2 7,0 0
OF PERM=
°'STRICT NO. p BY 0605-79
• COUNTY OF L0S ANGELES TETPLE CITY 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0802070006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: FEFS PAID BUILDING ADDRESS:
TR: 5904 IT: 222 UN: .002 9115 GARIBArnI AV
FEE DESCRIPTION: QUANTITY: DICK: AMOUNT: TEXP CA 917801622
ASSESSOR INFORMATION NUMBER: NiQUZMT CROSS STREET:
5384-010-001 01 PERMIT ISSUANCE FEE 27.75 T130M S PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
08 FURNACE/HEATUR <100 1.00 UNT 27.00
TENANT: 41 VENTILATION FAN 1.00 FAN 15.75 ISSURD ON: PROCESSED BY: PLAN BY: E[PIRE9 ON:
TOTAL FESS 70.50 02/07/08 SR 08/05/08
OWNER: TEL. NO: FpqAL DATE FINAL BY: CODE:
HUANG SHU YANG;SHOW JANE (626) 287-5263-
9115 GARIBALDI AV
TEND 917801622 DESCRIPTION OF WORK
RRFT.Af"Pt NA7.T. AND 1 VF.NTIIJ�TION FAN
APPLICANT: TEL. NO: ,vim^L
AMPS CONTRUCTI ON, INC. (626) 284-3260-
2618 X. MAIN ST. V _ SPECIAL CONDITIONS:
ALHAMBRA, CA 91801
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
AMPS CONSTRUCTION, INC. (626) 284-3260-
2618 X_ MAIN ST. LIC. NO FAU FUR.NA.E
ALHAMBRA, CA 91801 863573 B
- COl4BIISTION ASR OPE2UI7flG9
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
LIC. NO: AC CO�SOR
- TS-D�4TAT.
FIRE DAMPERS
SMIOICE DETECTION DEVICES
CCMORtCIAL HOOD
REPORT ID: DPR264 R.= TO: 1390508
COUNTY OF LDS ANGELES TENPLE CITY ¢ 0508 KEC ANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1112080021
BUILDING AND SAFETY / LAND DEVELORNENP TEt{PLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 242 UN: .002 9115 G RIBALDl AV
FEY DESCRIPTION: QC?d?r 'Y: DUN: A 4=: TEND CA 917801622
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5384-010-001 01 PERMIT ISSUANCE FEE 27.80 THOHAS PAGE: 596 GRID: H2 IOCALTl'Y: T24PLE CITY CA
08 FURNACE/HEATER <100 1.00 UNI 27.00
TEHAHT: TOTAL FEES 54.80 ISSUED ON: PROC&9SED BY: PLAN BY:
12/08/11 SR
ONNBR: TEL. NO: FINALIl
F CODE:
HUANG SHO YANGDSHON JANE (818) 286-8177- r
9115 GAR.IBAALDI AV r�I /'
TEMP 917801622_ DE!SCRIPfION OF WORK
ru9'1?J,, WALL HEATER
APPLICANT: TEL. NO:
BEN 4 LI CORPORATION -
SPECIAL CONDITIONS:
CONTRACTOR: T'EL. NO: APPROVALS DATE INSPECTZ7R SIGNATURE
BEH AND LI CORPORATION (626) 905-0077-
5657 ANDOVER WAY LSC. NO FAIT FURNACE
CH 1Q0 HILLS CA 91709 837201
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. NO: DUCT WORK
LSC. NO: AC COKRF.SSOR
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
REPORT ID: DP9-264 ROUTE TO: 1390508