HomeMy Public PortalAbout10241 LOWER AZUSA RD_Mechanical__ 76 A.�64'. �.B,e,- 9-7, CITY OF TEMPLE CITY
APPLICATION F611 PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER
ADDRESS Q
BUILDING
AND SAFETY DIVISION LOCALITY Temple City
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) MAI L Foodmaker
- Jack in the Rox 122
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS 10241 Lower Azusa Road
CITY TEL. NO. 442 93559
ABSORPTION UNIT, BTU Temple Cit-y
CONTRACTOR _
AIR HANDLING UNIT, CFM
ADDRESS 4236 Produce Plaza South
BOILER, BTU
CITY 1 os Angeles TEL. NO. 589 G751
2 COMPRESSOR, BTU_ l0 00 STATE 204402 LIC. VC_J20
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLERCD
FURNACE: FAUGRAVITY INSPECTION RECORD U
FLOOR BTU
HEATER: SUSPENDED UNIT_ C:)
WALL w
N
• z
Plan check fee 25% of above. See reverse.
PERMIT ISSUING F'EE S s 00
TOTAL FEE 13 100
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, VENT[- APPROVALS DATE INS TOR'S SIGNATURE
LAT ING, AIR CONDITIONING.
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACPING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS ND R)FESS IONAL FINAL
CODE OF THE STATE OF LIFORNIA.
SIGNATURE Ins llers S .. VALIDATI .N CK. M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATI VK. M.O. CASH •"�J�
1 IP, 3 1 ; 273 KP 13 4 1 D 1 3)X_jtJ� ,<<
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE