HomeMy Public PortalAbout5725 NOEL DR_Mechanical__ 76 A364 CE 818 1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CON01110NING
COUNTY OF LOS ANGELES ADDRESS 2 a
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
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NEAREST
ICROSSST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) W Olsen
MAIL
NO TYPE&SIZE OF EQUIPMENT FEE ADDRESS 5725 Oak
SEE BACK OF APPLICATION
CITY Temple City TEL NO 285-5974
1 FORCE AIR FURNACE BTU 1001111UO
CONTRACTOR
1 COMPRESSOR BTU 4—tori 5100
ADDRESS 1350 E. Las Tunas Drive
VENTILATION FAN CITY San Gabriel TEL NO 286-1141
LIST ALL OTHERS BELOW STATE LICENSE NO 221751 CLAC20
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T NO I GROUPCONE SSED Y
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INSPECTION RECORD
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Plan check fee See reverse ?
PI H\II 11551 INC F I I c 3 00
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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 ND LAWS REGULATING HEATING VENTI APPROVALS DATE INSPECTOR S SIGNATURE
LATING AIR COND ITIO N
ROJGH
I HEREBY CER IFY ATANESST ACTING IN VIOLATI0 )
OF CHAPTER 9 DI ISI
AND PROFES 0 L FINAL
CODE OF THE STA E IF
SIGNATURE PERMIT VALIDATION cK M o CASH
OF PERMITTE
PLAN CHIE&K VALIDATION6,K M 0 CASH
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7GA364-CESIB_8 e8 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONOITIONIN
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION _
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGY
ST
NEAREST
FOR APPLICANT TO FILL IN
(Print or type only) OWNER
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NO TYPEJOFAPPLIANCE OR EQUIPMENT FEE MAIL �l
ADDRESS
ABSORPTION SYSTEM BTU CITY TEL NO Zf6 6 6
AIR HANDLING UNIT CFM CONTRACTOR Q
BOILER HORSEPOWER ADDRESS /? c
COMPRESSOR HORSEPOWER CITY TEL NO
STATE LIC
VENTILATION SYSTEM LICENSE NO CLA _ — Z--
DISTRICTNO GROUP ZONE P CESSED BY
EVAPORATIVE COOLER
FURNACE FAU GRAVITY ✓ 4r . fj
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FLOOR—BT U INSPECTION RECORD
HEATER SUSPEND UNIT
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NEW—ADDITION— PERMIT $ 3 00
ALTER—REPAIR TOTAL FEE $
Plan check applicant
Name
Address
City Tel No
I HEREBY AC KNOW LEDG AT I HAVE READ THIS APPLICATION
AND STATE THAT THE AB E CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES D L WS REGULATING HEATING VENTI APPROVALS JOATE 1 PECTORS IG ATURE
LATING AIR CONDITIONIN w
ROUGH
I HEREBY CERTIFY HA I AM NOT ACTIN IN 1110 TI
OF CHAPTER 9 DIVISIO 3 F THE BUSINESS A PROFE 10 L FINAL O
CODE OF THE STAT FORNIA
JACK R ALLEN SUPERVISING MECHANICAL ENG R
SIGNATURE PERMIT VALIDATION CK M O CASH
OF PERMIT
PLAN CHE ALIDATION
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE