HomeMy Public PortalAbout9555 LA ROSA DR_Mechanical__ 76A364 - CEBIS - 3-69 APPLICATION FOR PERMI
HEATING - VENTILATING - AIR CONDITIONING p
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS d
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE, COUNTY ENGINEER LOCALITY [—` ���7
COLEMAN W JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL OWNER'
IN
(PRINT OR TYPE ONLY) - _
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS _5 $ �;
ABSORPTION SYSTEM, BTU 3 Or(/ CITY /fit NO �—
AIR HANDLING UNIT, CFM CONTRACTOR T /
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BOILER, HORSEPOWER ADDRESS - «�
- --�- - C I TY- 7i``7y ���/TE NO -
COMPRESSOR, HORSEPOWER STAT �� g� LIC C
LICENSE NO / CLASS
VENTILATION SYSTEM DISTRICT NO.;' GROUP ZONE PROc SSE v,
EVAPORATIVE COOLER
FURNACE FA AVITY
FLOOR BTU � � 6,0 INSPECTION RECORD
HEATER SUSPENDED UNIT —/-4
— 7e9 G/ FG7 00
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PERMIT $ 3 00 z
NEW_ADDITION_ J "
ALTER--REPAIR— TOTAL FEE
PLAN CHECK APPLICANT
NAME r
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI-
LATING, AIR CONDITIONING. APPROVALS DATE INSPECTOR'S SIGNATURE
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH -
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STA�DFLIFORNIA —.� D //
SIGNATURE ' JACK R. ALLEN, SUPERVISING MECHANICAL ENG'
Of PERMITTEE - PERMIT VALIDATION CK. - M.0 CASH
PLAN CHECK VALIDATION
SEE BACK-OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
,l DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 1108020002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID FEES PAID BUILDING ADDRESS
ITR 13620 LT 22 9555 LA ROSA DR
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803827
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1
18590-014-010 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY, Cl
1 102 COMPRSR < 100 KBTU 1 00 COM 27 00 1
ITENANT 108 FURNACE/HEATER <100 1 00 UNI 27 00 (ISSUED ON PROCESSED BY PLAN BY
130 AIR INLETS/OUTLETS 9 00 UNI 39 10 108/02/11 SR
TOTAL FEES 120 90 1
(OWNER TEL NO IFINALDATE FINAL BY CODE
SAKAIDA, HENRY/DONNA (626) 277-9290- Ien" X f
19555 LA ROSA DR I I!\
ITEMP 917803827 1 IDESCkIiPTION OF WORK 141
IFURNACE & A/C CHANGE OUT
I ' I I
(APPLICANT _ _ TEL _NO
IR D SMITH HEATING & A/C (626) 334-7847- I _
1850 W FOOTHILL BLVD I ISPECIAL CONDITIONS
IAZUSA, CA
ICONTRACTOR TEL NO I (APPROVALS 15ATE INS CTOR SIGNATURE
IR D SMITH HEATING AND AIR (626) 334-7847_ I I I
1850 W FOOTHILL LIC NO I IFAU/WALL FURNACE - �(
IAZUSA, CA 91702 635348020 I �(
ICOMBUSTION AIR OPENINGS I
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1ARCHITECT OR ENGINEER TEL NO IDUCT WORK I I I
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LIC NO I IAC/COMPRESSOR
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IREPORT ID DPR264 ROUTE TO BS0508
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