HomeMy Public PortalAbout5234 KAUFFMAN AVE_Mechanical__ 76 A364 - CE BIB - 9-71 APPLICATION FOR PERMIT
HEATING = VENTILATING - AIR CONDITIONING
.COUNTY OF LOS ANGELES' � ADDRE7NG ,,l
DEPARTMENT OF COUNTY ENGINEERBUILDING AND SAFETY DIVISION LOCAL
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
- MAIL �
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CIT TEL. NO.
ABSORPTION UNIT, BTU
•CONTRACT R _
AIR HANDLING UNIT, CFM ADDRESS 3 ea
BOILER, BTU CIT TEL. NO.-I
COMPRESSOR, BTU �pn da STATE / LIC.
LICENSE NO. f CLASS
VENTILATION SYSTEM DISTRI T NO. GROUPZONE CESSED BY
EVAPORATIVE COOLER
FURNACE: FAU y" GRAVITY Zo
FLOOR BTU 0 G� INSP TION RE RD C:)
HEATER: SUSPENDED UNIT_ O
1—
WALL' W
. � Z
/
A.s
Plan check fee 257. of above. See reverse.
PERMIT ISSUING FEE $ 3 00
TOTAL FEE 16'v
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, VENTI- APPROVALS D TE �INSPEC R'S SIGNATURE
LATING, AIR CONDITIONING. ,
ROUGH _ - -
I HEREBY CERTIFY ,THAT I AM NOT ACTINGI V10_ ATION '
"OF CHAPTER 9, DIVISION 3 )TUBUSINESS ANr ZONAL FINAL
CODE OF THE STATE OF F
SIGNATURE PERMIT VALIDATION
OF PERMITTEE � CK. M 0. CASH
PLAN CHECK VALIDATION CK. M.0. CASH
C.9 5. S 7 4 1 D 13.00-
SEE
3.00-SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1101180010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID- FEES PAID I BUILDING ADDRESS:
ITR: 15683 LT: 28 5234 KAUFFMAN AV
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT TEMP CA 917803947
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: I
18589-010-028 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
1 141 VENTILATION FAN 1.00 FAN 15.80 I
(TENANT: I TOTAL FEES 43.60 (ISSUED ON: PROCESSED BY: PLAN BY:
101/18/11 SR
OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE:
IT. ROMERO (626) 614-0546- 1 1 I
15234 KAUFFMAN AV I I I
ITEMP 917803947 I IDESCRIPTION OF WORK I
I IVENTILATION FAN FOR BATHROOM IMPROVEMENT I
I I I I
(APPLICANT: TEL. NO: I I 1
IJIMENEZ, MANUEL (818) 262-6047- I I 1
15419 SUNSET BLVD. I ISPECIAL CONDITIONS: I
ILOS ANGELES CA 90027 1 1 1
I I I I
I I I I
(CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
IQUALITY CONSTRUCTION (818) 262-6047- 1 1
129831 VISTA DEL ARROYO LIC. NO I IFAU/WALL FURNACE I I 1
IAGOURA HILLS CA 91301 852512 B I 1 11 1
I ICOMBUSTION AIR OPENINGS I 1 1
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(ARCHITECT OR ENGINEER: TEL. NO: I IDUCT WORK I I I
I - I 1 I I
I LIC. NO: .1 IAC/COMPRESSOR I 1 1
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ITHERMOSTAT 1
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I I IFIRE DAMPERS 1 1 1
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IREPORT ID: DPR264 ROUTE TO: BS0508 I I I 1
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