HomeMy Public PortalAbout9031 HERMOSA DR_Mechanical__ 76 A364 CE 018 -1275
APPLICATION FOR PERMIT /
ej HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS
" DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. �({
FOR APPLICANT TO FILL IN (OWNER
(PRINT OR TYPE ONLY)
MAIL '
TYPE&SIZE OF EQUIPMENT h /
NO. . SEE BACK OF APPLICATION FEE ADDRESS
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FORCE AIR FURNACE, BTU CITY TEL. NO.
CONTRAC OR
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN - - n
CITY TEL. NO O
LIST ALL OTHERS BELOW STAT LIC.
LICE SE NO. CLAS
LSir 40 J3 rx /•�VI J, DISTRICT NO. GROUP ZONE PROCESS EO BY
INSPECTION RECORD
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Plan check fee'- See reverse. ?
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PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
H
EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STAiE THAT THE ABOVE IS COPD ECT AND AGREE TO COMPLY
WIT HALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- F APPROVALS DATE INSPECTOR'S SIGNATURE
LAT ING, AIR CONDITIONING.
ROUGH X77
I HEREBY CERTIFY THAT I AM NOT TING IN VIOLATION
OF CHAPTER S, DIVISION 3, OF THE BU61 55 ANO PROFESSIONAL FINAL D-?� C
CODE OF THE , DI OP C/3, - RTI A.
SG
PERMIiTTE=__ _ PERMIT VALIDATION M.0. DASH
PLAN CHECK VALIDATION CK M.O. CASH V
465rOCT 13 4.1 D 1 2.00A
COUNTY-QF LOS ANGELES TEMPLE CITY k 0508 MECHANICAL PERMIT
DEPARTMENT OF,PUBLIC WORKS 9701 LAS TUNAS ME 0506 1310030006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS: 1
ITR: 5904 LT: 307 1 9031 HERMOSA DR 1
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917001836
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ROSEMEAD
15384-016-043 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI
141 VENTILATION FAN 1.00 FAN 15.80
ITENANT: I TOTAL FEES 43.60 11SSUED ON: PROCESSED BY: PLAN BY: 1
110/03/13 SR 1
IOWNER: TEL. N0: iFINA1,,DATEL BY: CODE:
ISTROBEL, CHARISE
19031 HERMOSA OR _ V
TEMP 917801836 SCRIPTION OF WORK
VENTILATION FAN FOR A BATHROOM REMODEL
(APPLICANT: TEL. NO:
SAME AS OWNER -
ISPECIAL CONDITIONS:
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1CONTRACTOR: TEL. F0: 1 (APPROVALS GATE INSPECTOR SIGNATURE 1
SAME AS OWNER -
LIC. NO I IFAU/WALL FURNACE
I I
I I IGDMBDBTIDN AIR OPENINGS
I
1ARCHITECT OR ENGINEER: TEL. NO: II DUCT WORN
II I I
LIC. NO: i 1AC/COMPRESSOR I I I
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I I (THERMOSTAT I I I
I IFIRE DAMPERS
ISMO KE DETECTION DEVICES
I I (COMMERCIAL Hoop I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
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1REPORT ID: DPR264 ROUTE TO: BS0508