HomeMy Public PortalAbout9931 / 9227 GARIBALDI AVE_Mechanical__ 7&►364C�CE-81819) 4n7 APPLICATIOW FOR PERMIT
HEATIWG - VENTILATING - AIR CONDITI-ONING
CITY- OF TEMPLE CITY
BUILDING AND SAFETY DIVISIONLiC #2272
FOR APPLICANT TO FILL IN SUILDING9927 aribaldi
(PRINT OR TYPE ONLY) ADDRES
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOC&L". Tele City ,
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU OWNER John Self.
AIR HANDLING UNIT,CFM MAIL
ADDRESS. 2023 Bella
/n�''[Vis"
{�W45_
BOILER BTU CRY Arcadia Cg N091006 .
1 COMPRESSOR,BTU —1 Ton 10 00 CONTRACTOR
jjnd
VENTILATION SYSTEM ADDRESS 2379 First St. ,
EVAPORATIVE COOLER C)TYoerAe TEL NQ 3391-601-1
1 FURNACE: FAU X 6Y 10 STATE lLIC.
FLOOR BTU OLJ,['1 00 LICENSENO. 2tl 1LV95 CLASS
HEATER: SUSPENDED UNfT DLSTRICT NO. GROUP ZONE EaaFn Rr
WALI
INSPECTION RECORD
Plan check fee 25% of above.
PERAM ISSLHNG FEE$
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO.
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE LS CORRECT AND AGREE TO COMPLY WT H ALL .
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDMONING.
I HEREBY CERTIFY THAT I AM N91 ACTING IN VIOLATION OF APPROVALS DATE IK"ECTOR3 SIGNATURE
CHAPTER D, DfVISION 3, OF THE BUSIN S AN ROFESSIONAL CODE ROUGH Z -�
OF THE STALRNUL -
OF THE TA FINAL
OF PE RM ITTE44
PLAN CHECK VALIDATI C M.o, usH PERMIT VALIDATION cIL M.0. CASH
WO'r%"< r-RS COMPENSATION
POLICY HOLDER: ,g 9 hAP�; 17 4,l D 2 'P.0 0 �a
,POLICY NUMBER: