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76A364-CE818`-1/70 APPLICATION FOR PERMIT
HEATING VENTILATING - AIR CONDITIONING .
CITY OF .TEMPLE-,CITY -7671
COUNTY OF LOS ANGELES I
DDRESS 0686 Keywet
DEPARTMENT OF COUNTY ENGINEER,
BUILDING AND-SAFETY DIVISION OCALITY - Templeflty
JOHN A.,LAMBIE.-COUNTY ENGINEER, EAREST
: -COLEMAN W.'JENKINS, SUPERINTENDENT•OF BUILDINGROSS ST:'
El TJ! rite -Ave'.
FOR APPLICANT TO FILL IN WNER,John ,Sell
' (PRINT OR TYPE ONLY) - - • ' -,'
' MAIL .•
NO. TYPEO,FAPPLIANCEOR EQUIPMENT FEE q'DDRESS2023' Bella V1St.a Drive, •
CITY Arcadia,-• TEL_: N0445-2772
'ABSORPTION SYSTEM, BTU
CONTRACTOR J & J- Htg& A/C Serv.Cor
AIR HANDLING UNIT, CFM ADDRESS 237'9 -Firs,t ,St . ,'
BOII.ER,;HORSEPOWER
CITY La Verne TEL. NO. -6011
Z COMPRESSOR, HORSEPOWER 3T— 5.00 STATE LIC. `
LICENSE NO. 2616-95 CLASS C20
VENTILATION SYSTEM DISTRICT NO. I CLASS GROUP ZONE j PROCESSED.BY
EVAPORATIVE COOLER (Y y
FURNACE: ',FAUGRAVITY v INSPECTION RECORD
FLOOR BTU ^"
HEATER: ,SUSPENDED UNIT_
WALL-
CD
_ - O
LV
cln
NEW—ADDITION— :PERMIT $ '3• 00 ?
'ALTER_REPAI'R_TOTAL FEE $ ,8 QQ
PLAN CHECK APPLICANT
NAME
• v _ is
:ADDRESS
CITY TEL.NO. .. ;
L:HE REBY 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 'DATE CTOR'S SIGNATURE
'LATING,+AIR CONDITIONING. _
ROUGH
I' HEREBY CERTIFY THAT I AM, T CTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE'BU E S AND PROFESSIONAL FINAL ,/ -
,CODE OF THE STATE OF'CALIFORN - '
SIGNATURE JACK R. ALLEN,SUPERVISING'MECHANICAL•ENG'R.
OF"PERMITTE - -
PERMIT VALIDATION CK. CASH
PLAN-CHECK VALIDA ION
SEE BACK OF APPLICATION FOR COM PLET.E FEE SCHEDULE
•76A36d'-C€81ff'-1/70 APPLICATION FOR PERMIT -
HEATING - VENTILATING- AIR CONDITIONING
CITY OF TEMPLE CITY 7671
COUNTY OF LOS ANGELES ADDRESS 10686 Ke west
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY Temple Cit
JOHN A: LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN OWNER John Sell-,
- (PRINT OR'TYPE ONLY) MAIL
NO. TYPE OT APPLIANCE-OR EQUIPMENT FEE ADDRESS 2023 Bella .Vista Drive
CITY Arcadia TEL. No4,45-277'2
ABSORPTION SYSTEM, BTU
CONTRACTOR j & J Htg & A C. S e rV Cup
AIR HANDLING UNIT, CFM
ADDRESS 'Z 3,7 9 .F1r'St St • r.,
BOILER, HORSEPOWER CITYTEL. NO. 39=6011
La Verne 3
COMPRESSOR, HORSEPOWER STATE . LIC.
LICENSE NO. 2'61695 CLASS C20
VENTILATION SYSTEM DISTRICT NO CLASS GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER' �S-� ll' ��(i✓�-.�_
FURNACE: FAU_GR �x{{��Y INSPECTION RECORD
1 FLOOR BTU '�v1Y1 5.00
HEATER:..SUSPENDED UNIT_
WALL
o_
" O
' O
' U
W
V:
NEW-ADDITION_ PERMIT $ 3 00 Z
ALTER-REPAIR- TOTAL FEE $ 8. 00
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'LA'WS REGULATING HEATING, VENTI- APPROVALS DA E •I ECTOR' SI ATURE
LATING, AIR CONDITIONING.. -
' ROUGH _
I HEREBY CERTIFY THAT I OT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF T NESS AND PROFESSIONAL FINAL
CODE OF THE STATE F CALIFORN A -;41 -
SIGNATURE JACK R. ALLEN,SUP RVISING ECHANICAL ENG'R.
OF PERMITT E �i -fit
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VAL1 ATION
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76'A 364 -CE 618-1/75 -
APPLfC 70'N FOR -PER
HEATING - :VEN'TILATIN G'- AIR C 01140NING'-
COUNTY OF LOS ANGELES BUILDING
DE'P'ARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND ,SAF.ETY DIVISION LOCALITY.
NEAREST. /
CROSS ST.
-FOR ,APPLICANT:TO FILLJN- OWNER p.
(PRbNT;OR TYPEONL•'Y) AMM
N0 TYPE&SIZE•OF EQUIPMENT ;FEE 'MAIL''ADDRESS e`
SEE BACK OF APPLICATION: -
- CITY. L. NOS
.r�.;•`. FORCE`AIR FURNACE, BTU. -
;, '•:1 'CONT RACTORI
COMP.RESSOR,;BTU r,. ADDRESS '
VENTILATION(F'A'N. CITY �" TEL. NO �
- Y'.
STATE' LIC.`
LIST ALL OTHE'RS'BELO.W''- + '+' s
;LICENSE NO.. CLASS �'^
DISTRICT N0. - G OUP, QONE SSED BY .
- INSPECTION RECORD
„ . v
Plan check fee:'-See rev'e'rse. ' . z
YI 'lt�Il`f'IStiL� 'C FF,I: 3 00
PLAN CHECK APPLICANT
kl6y
NAME
ADDRESS
CITY ' ��. TEL.N
d
•P HE RE BY ACKNOWLEDGE-THAT-IIHANE READ THIS APPLICATION
AND STATE'THAT THE ABOVE IS CORRECT AND`AGREE TO COMPLY
WITH ALL.ORDINANCES AND LAWS 'REGULATING HEATING, -VEN71-' APPROVALS DATE lNSPECTOR'S.SIGNA7URE
FLAP ING, AIR CONDITIONING', + -
s ROUGH ,t;
I HE REBY� CERTIFY• AT -I AM NOT ACTING IN•VIO ATI
.✓OF'CHAPTER 9, DIVI510 _ 0 E BUSI SS AN PROFE 'IO L NAL x !��• •��
CODE OF THE STATE OF LI ORNIA. ,
SIGNATURE PERMIT V"A'LIDATION ' :CK.`. M.0. CASH
OF PERMITTEE' - ,
PLAN CHECK VALIDATION', CK.. •.O. CASA•"
5,4.-6�JUN 3.t 1.. :y �0,:5,� A9