HomeMy Public PortalAbout8755 HERMOSA DR_Mechanical__ ]BA 364_C E816—8-65 APPLICATION FOR PERMIT [�
HEATING - VENTILATING - AIR CONDITIONING lul
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 55 u
COLEMAN W. JENKINS, SUPERINTENDENT OP BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN caoss sT. Rosemead & Las Turias
(Print or type only)
OWNER S
No. TYPEIO F APPLIANCE OR EQUIPMENT FEE
MAIL Tobn ADDRESS 2023 Bella Vista,
ABSORPTION SYSTEM, BTU CITY Arcadia TEL. N0445-2772
AIR HANDLING UNIT, CFM CONTRACTOR) &.J Ht & ASC SErv.Corp
BOILER, HORSEPOWER ADDRESS237C) Pi t
COMPRESSOR, HORSEPOWER CITY La Verne TEL. NO 339-6011
STATVENTILATION SYSTEM LICE SENO. 261695 CLAS$ C20
DISTRICT NO. GROUPZONE PROCESSED BY
EVAPORATIVE OLER Q_J�,
1 FURNACE: FAU—CGRAVITY S o of 1 lO✓u�
FLOOR—BTU Rom to 5 00 INSPECTION RECORD
HEATER: SUSPENDED—
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NEW_ADOITION PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ 1 8 OO
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 ALL ORDINANCES AND LAWS REGULATING HEATING, VENTL APPROVALS DATES / INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING, ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, OIVI SION 3, OF TXE BUSINESS AND PROFESSIONAL FINAL y j_'e-7,1
CODE OF THE STATE OF CALIFORNIA.
/� JACfK R. ALLEN,SUPERVISING M CHAWCAL ENG-R.
SIGNATURE G PERMIT VALIDATION CK. M.O. CASH
OF PERURE E
PLAN CHECK VALIDA n .'
624X"JAN 2941 D 8.00aC
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
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]ON]OAE- CE919B-9/75 —p`ppL AATI0N FOR PERMIT
HEATING - VV ENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING I
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY P,,�,_
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
v
AIR HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU CITY ` TEL. NO.
COMPRESSOR, BTU CONTRACTOR /' IC, /
A FO/1
VENTILATION SYSTEM ADDRESS Cetjb1
EVAPORATIVE COOLER CITY TEL. NO.
FURNACE: FAUGRAVITY STATE // LIC.
FLOOR BTU LICENSE NO. /mesio-i CLASS
HEATER: SUSPENDED_UNIT DISTRICT NO. GROUP zoNE OCESSED BY
WALL
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INSPECTION RECORD H
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Plan check fee 25% of above.
PERMIT ISSUING FEE $ o j 0 j
TGTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY y / TEL.NO,/Sj
A
HEREBY ACKNOWLEDGE THAT I HAVE REND THISTION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF NAPTEfl 9, DIVISIONON 3 NESNO PROFESSIONAL ROUGH
( CODE OF THE STATE OF CALI IA. O///G'//�// A
I" SIGNATURE 7
OF PERMITTEE FINAL ! 7//! 44r, s
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONr�n-.-� M.D. CASH
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