HomeMy Public PortalAbout9567 PENTLAND ST_Mechanical__ 8A36y�,c,eq,B�_6B APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES t I
bEPARTMENtiT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION JOHN A. LAMBIE. COUNTY ENGINEER 76
76
COLEMAN W. JENKINS, SUPERINTENDENT QF BUILDINGYGST
FOR APPLICANT TO FILL IN . AO
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(Print or type only)
OWNER C
No.. TYPE1OFAPPLIANCE OR EQUIPMENT FEE
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ABSORPTION SYSTEM, BTUq
2Ldlll� O CITY dE TEL. NO.
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AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS r
COMPRESSOR, HORSEPOWER CITYON�G v TEL. NO: 1 3��
STATE LIC.
VENTILATION SYSTEM LICENSE=NO. CLASS
DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER /^ �O
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NEW ADDITION— PERMFT. S 3 00
ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
ELATING,
Tel. No.
EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
E THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
L ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS D TE ECTO NATURE
AIR CONDITIONING. ROUGH
REBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION FINAL
ER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL
THE BTATE LIFORNIA. JACK R. ALLEN,SUE 1 CHANICAL ENG'R.
UPERMIT VALIDATIO CK. M.O. CASH
MITTE
PLAN CHECK VALIDATION
LA,co'_q 5 3-.0 APH22 4 41 D 1 1,QO-
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
7GA364E-C2518011 9143 APPLICATION FOR PERMIT
"4 HEATING - V TILATING - AIR CONDITIONING
BUIL I G AND
SAFETYN
FOR APPLICANT TO FILL IN IUOR�s" 9567 Pentland
(PRINT OR TYPE ONLY)
AL
LOCALITY' Temple City
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER Mrs. NanC stem '
AIR HANDLING UNIT, CFM MAIL
ADDRESS 9567 Pentland
BOILER, BTU - /00-0 CITY Temple City TEL. NO. 287-0018
1 COMPRESSOR, BTU -ton
CONTRACTOR Bryant Heat. & Air Cond. Inc.
VENTILATION SYSTEM ADDRESS 1350 E. Las Tunas Drive
EVAPORATIVE COOLER CITY . San Gabriel TEL. No. 286-1141
FURNACE: FAUGRAVITY STATE' LIC. C2O
FLOOR BTU' 221751 LICENSE NO. CLASS'
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE SSED BYCD
4-
WALL
� J • _ �` � CO
INSPECTION RECORD`
Plan check fee 25% of above.
PERMIT ISSUING FEE $ ,
TOTAL FEE •
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, VENTI-
LATING, AIRCONDITI 0.
1 HEREBY CERT FY THAT I AM[NOT TIN6 IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE '
OF CHAPTER 9, D.IVI 3, OF THE RVSi S AND PROFE SIONAL
CODE OF THE STA ALIFORNIA. �/ ROUGH
SIGNATURE
OF PERMIT E �/���/// f FINAL .Y4 .5..
PLAN CHECK VALIDATION M.o. CASH PERMIT VALIDATION cK. M.o.. cases
WORKERS C®MpENSA'T 1014
0. 8 Z c`1:APR '21 4.1. 0 1:. -7.a o m-99
POLICY HOLDER .1it�
POLICY NUMBER; C C C7 G 3'S �Y