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CC BIB(REV e/9e1 1
o. APPLICTION FOR PER IT
HEATING - VENTILATING: AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
BUILDING
FOR APPLICANT TO FILL IN ADDRESS 6 Pal Mal Avenue
(PRINT OR TYPE ONLY)
NO TYPE,O F,APP LIAN CE OR EQUIPMENT FEE 1 LOCALITY Temple Cit
NEAREST ,
CROSS ST
ABSORPTION UNIT BTU
v OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS 5647 Pal Mal Avenue
BOILER BTU 'CITY Temple City- TEL NO 446 381
COMPRESSOR BTU CONTRACTOR
AAA' Conditioned Air ,
VENTILATION SYSTEM ADDRESS 10160 Valley Blvd.
EVAPORATIVE COOLER CITY El Monte TEL NO 579 180
FURNACE FAU_GR VITY ,y STATE LIC
FLOOR BTU �U LICENSE NO 2935?9 CLASS C20
HEATER SUSPENDED—UNIT— APPROVALS DATE 0 CTORS SIGNATURE
WALL
ROUGH
FINAL 2.5 jz 7 XL��J O ,
INSPECTION RECORD I V
IN
OOj
Plan check fee 25% of above ' 6
PERMIT ISSUING FEE;- _ IL
I ` , TOTAL FEE
PLAN CHEC K APPLICANT i PLAN CHECK VALIDATION
NAME
" J
ADDRESS` I ,
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI5 APPLICATION AND Y9 5 5 8 A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS ,REGULATING HEATING VENTILATING AIR # . . . e 4
CONDITIONING PERMIT VALIDATION O
HEREBY CEO FY HAT I'�AM ACTING IN VIOLATION OF Q .�. J O 0
CHAPTER 9 DIVISI 3 F E BUSINES ND PROFESSIONAL CODE '
OF THE STATE OF C U R IA ,�(//J . . . TOO U
SIGNATURE X-
OF PERMITTEE 1'
DISTRICT NO P S BY 1 ` 0326'-80
'
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