HomeMy Public PortalAbout6106 IVAR AVE_Mechanical__ 76A36 E >E-6,6A1-11/76 APPLICATION FOR,PER
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LCYJ GELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY) • �� T;,._ "-
LOCALITY ,
NO. TYPE OF APPLIANCE OR EQUIPMENTFEE'
NEAREST -
. - - CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL w'
ADDRESS �. �O .. lV:t_` ✓�F_
BOILER,BTU -
CITY .; STEL.NO.
COMPRESSOR,BTU
.CONTRACTOR -
VENTILATION SYSTEM ADDRESS
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EVAPORATIVE COOLERCITY TEL._N
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FURNACE: FAU GRAVITY STATE LIC. '
FLOOR BTU -
LICENSE NO. • �'� CLASS'
- \
HEATER: SUSPENDED UNIT
DISTRICT NO. - ��G�OUPE PROCESSED BY
..WALL
ff] v INSPECTION RECORD x, O
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Nan check fee 25% of above. P
PERMIT ISSUING FEE. "�U t
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.TOTAL FEE L.
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, VENTILATING, AIR -
CONDITIONING. I • . - '
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF_- APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND,PROFESSIONAL CODE
OF THE.ST _ LIFORN_IA. ROUGH
SIGNA URE _ FINAL,
OFFER ___ -
PLAN,CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION SCK:: M.O. CASH
WORKERS COMPENSATION
POLICY HOLDER: C
POLICY NUMBER:
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0208150014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL 10: FEES PAID BUILDING ADDRESS:
TR: 5904 LT:,44 6106 [VAR AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801523
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBALDI
5384-002-015 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: PROCESSED BY: PLAN Y: EXPIRES ON:
30 AIR INLETS/OUTLETS 10.00 UNI 43.50 08/15/02 JK 02/11/03
TOTAL FEES 125.25
OWNER: TEL. NO: FI�N1AL DATE FINAL BY: CODE:
LY LAM THAI;VAN TRINH (626) 285-6444-
6106 IVAR AV QQ
TEMP 917801523 DESCRIPTION OF WORK
NEW HVAC SYSTEM
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. N0: � - �" ���� APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO FAU/WALL FURNACE
COMBUSTION A I R OPENINGS
ARCHITECT OR ENGINEER: TEL. N0: / � ' ^.I�i'� ! ��� �, �% DUCT WORK
LIC. NO -� AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMERCIAL HOOD
4
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REPORT ID: DPR264 ROUTE TO: SS0508