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APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS 91f'27 Olema
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY Temple City
NEAREST
CROSS ST. Oak
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) John MarshallConst.
MAIL
' NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE
ADDRESS 5926 Temple City Blvd.
ABSORPTION UNIT, BTU CITY Temple City TEL. NO- 286-9822
CONTRACTOR A. PInc.
AIR HANDLING UNIT, CFM
ADDRESS BOX 3067
BOILER, BTU CITY Pasadena TEL. NO. 792-2177
COMPRESSOR, BTU STATE - 62
LIC. C20
LICENSE NO. 220862 CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER D
FURNACE: FAU_GR5 e 00 INSPECTION RECORD v
FLOOR BTU
]. WTV
HEATER: SUSPENDED UNIT_
WALL w
' Z
1
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 3 00
TOTAL FEE 1 8.00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
LNDSTATE
BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
E THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
IR CONDITIONING.
ROUGH
EBY CERT Y THAT AM NOT TING IN VIOLATIONER 9, DIVI ION 3, OF T E BUS S IONAL FINAL
THE STATE ALIF R A.
URE PERMIT VALIDATION K. M.O. CASH
MITTEE
PLAN CHECK VAKIDATION CK. M.O. CASH
SEP 14 4 1 8.00M
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ,