HomeMy Public PortalAbout4819 KAUFFMAN AVE_Mechanical__ v
76A364E- CES18B-9/75 APP A p ION 1F��;OCC//; 11MIT -
HEATING - VENTILATIHG -AIR CONDITIONING
BUILDING AND SAFETY DIVISION L,J� TSF- 1,v--z v
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS _
figan ave,
IV
LOCALITY Temple City
No. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEAREST
.. ,. CROSS ST. Lower Azusa Rd.
ABSORPTION UNIT, BTU
- OWNER
AIR•HANOLING UNIT, CFM MAIL [
ADDRESS 5926 Temple City Blvd.
BOILER, BTU. Call
CITY Tempe G�ity TEL. NO. 286_2818.
COMPRESSOR, BTU �6 CONTRACTOR
David L. Pe.
VENTILATION SYSTEM ADDRESS 124 Wheeler
EVAPORATIVE COOLER CITY Arcadia TEL. NO. 446-8752
FURNACE: 'FAU GRAVITY STATE LIC.
FLOOR BTU J�7_.iC_.. ` LICENSE NO. 257509 CLASS 0-20
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE SSED,BY y-
C
WALL O
INSPECTION-RECORD 00
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE
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
WITHALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- -
LATING, AIR CONDITIONING. ,
IHEREBY CERTIFY T I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISI N 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE:'STATE,, FCA IFORNIA. ROUGH r/
SIGNATURE I /
OF PERMITTE FINAL "- D �6�
PLAN CHECK VALIDATION _ PERMIT VALIDATION / ��• M.O. CASH
CK, M.O. CASH
O'CC`
213Z S 03
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