HomeMy Public PortalAbout4826 KAUFFMAN AVE_Mechanical__ 7GA364E - CE@"188-9/75 APPLICATION
FORPIGRMIT
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY_,.DIVISION XSZa `
,FOR APPLICANT TO FILL IN BUILDING Z
(PRINT OR TYPE ONLY) ADDRESS
auffman Ave*
No. TYPEOFAPPLIANCEOR EQUIPMENT FEE LOCALITY Temple City
NEAREST
CROSS ST. , Lower Azusa Rd.
ABSORPTION UNIT, BTU "
OWNER. -
AIR HANDLING UNIT, CFM MAILp
ADDRESS 5926 Temple City Blvd. p
BOILER, BTU CITY Temple City TEL. NO. 286=2818
COMPRESSOR, BTU A_ CONTRACTOR
VENTILATION SYSTEM ADDRESS 124 wheeler
EVAPORATIVE COOLER CITY Arcadia
TEL NO. 446-8752
FURNACE: FAU GRAVITY STATE 287502 LIC. C�20
FLOOR BTU LICENSE NO. !J CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP J��ZONE P ESSED BY
WALL Q _
C
INSPECTION RECORD o
v
W
N
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 -
WITH ALL 0ROINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR
ENT1-LATING, AIR CONDITIONING. -
I HEREBY CERTIFY THAT 1 AM "NOT ACTING IN'VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DTVI ON 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STAT F C LfFOR NI'A. ROUGH. .. a
SIGNATURE t
OF PERMITTEE / FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CASH
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