HomeMy Public PortalAbout9572 PENTLAND ST_Mechanical__ • " • TEMPLE CITY 5054206 .
76 A364- CE 818- 543
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONOITIONI'NG
COUfVTY QF I QS ANGELES FADDRESS
DEPARTMENT OF COUNTS(—ENGINEER 9572 Pentland St.
BUILDING AND SAFETY DIVISION Y Temple City 91780
.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) Margaret W. Std' �$
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS 9572 Pe'ritland St.
ABSORPTION UNIT, BTU CITY Temple Cl ty TEL. NO. 448-6720
CONTRACTOR in Inc*
AIR HANDLING UNIT, CFM ADDRESS •
BOILER, BTU CITY SFS 9 TEL. NO.69g_
1 2511
COMPRESSOR, BTU�p STATE LIC.�u u�� oo LICENSE NO. 208916 CLASS C-20
VENTILATION SYSTEM DISTRICT NO. GROUP ZO OC S BY
ow-EVAPORATIVE COOLER (/
FURNACE: FAU__LGRAVITY INSPECTION RECOR
1 FLOOR BTU 5 00
HEATER: SUSPENDED UNIT_.
WALL
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Plan check fee 25% of above. See reverse. z
PERMIT ISSUING FEE S 3 00
TOTAL FEE 13 00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS RE ULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING#fA
• ROUGH
1 HE CERTIFY NOT ACTING IN VIOLATIONOF CHAPTER 9, DIVISIONINENDPRO.FESSIONAL FINALCODE OFTHE STATE OF CR
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH
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