HomeMy Public PortalAbout4833 KAUFFMAN AVE_Mechanical__ 76A364E - CE:B188 9/75 - APPLI TION FOR. PERMIT
HEATING.- VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION �j O
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS- auffman Ave. :
'
NO. TYPE OF APPLIA NCE OR EQUIPMENT FEE LOCALITYTepipleCity_ NEAREST
CROSS ST. bower Azusa 'Rd.
ABSORPTION UNIT, BTU
OWNER b
er
AIR HANDLING UNIT, CFM MAIL -
ADDRESS 5926 Temple City Blvd.
BOILER, BTU CITY Temple City TEL. NO. 286-2818
COMPRESSOR, BTU ���1d1
CONTRACTOR David L Peacock -I
VENTILATION SYSTEM ADDRESS 124 Wheeler
EVAPORATIVE SOOLER CITYArcadia
TEL
NO. _8 2
FURNACE: FAU GRAVITY STATE LIC.
FLOOR-BTU LICENSE:NO. 8 Q CLASS '
HEATER: SUSPENDED UNIT_ OISTRICT'NO. GROUP ZONE SED BY
WALL
INSPECTION RECORD
U
W
a
' co
Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS,CORRECT AND AGREE TO COMPLY
WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI-.
LATING, AIR CONDITIONING:
HEREBY CERTIFY 'THAT"-I AM NOT ACTING IN VIOLATION -APPROVALS DATE INSPECTOR'S SIGNATURE-
OF CHAPTER 9, DIVIS 13,'OF THE BUSINESS AND PROFESSIONAL
CODE OF THESTATE F CALIFORNIA. ROUGH
SIGNATURE
OF PERMITTE4���
FINAL
PLAN CHECK VALIDATION, cK. M.O. cnsH PERMIT VALIDATION � M.O. CASH
8 ,' 3
� � 61-2