HomeMy Public PortalAbout5331 PERSIMMON AVE_Mechanical__ 76A354•t,$,=.8 18-1/75
APPLICATION FOR PERMIT
HEATING - VENTILATINP AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY,.. ENGINEER ADDRESS 5331 No. Persimmon Ave.
BUILDING AND SAFETY DIVISION LOCALITY Temple City
NEAREST
CROSS ST. -Grand
'FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)) Mr. and Mrs. B. WI se arver
MAIL
TYPE&SIZE OF EQUIPMENT,)J ADDRESS FEE 5331 No. Persimmon Ave.
SEE BACK OF APP1_ICAT10 fj
1 FORCE AIR FURNACE, BTU _60,Ono CITY Temple City
TEL. NO. 448-]8]2
00 CONTRACTOR
1 COMPRESSOR, BTU _309000 . 10 .00 - E L. Payne
ADDRESS L66 W. Live Oak
VENTILATION FAN _ CITY Arc ad la TEL. NO. 446-6118
LIST ALL OTHERS BELOW STATE 120228 LIC. C-20
LICENSE NO. CLASS
DISTRICT NO. GROUP ZONE PROCE EDBY
-
INSPECTION RECOR
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Plan check fee. See reverse.
PRR111T IssuINC FEE-', S 73 QO
TOTAL, FE(; 27 00
PdAN 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 ORDINANCESAND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPEY T $SIGNATI iE
EATING, AIR CO ND ITIONIN,G. 1p
ROUGH
I HEREBY CERTWY T I AM NOT ACTING IN VIOL ON
OF CHAPTER 9, DIVI 14 3 OF THE BUSIN S AND PRO.FES I NAL FINAL O;N
CODE 0F THE STATE IFORNIA.SIGNATUREPERMIT VAL9CK:a" M.0 CASH
OF.PERMITT
PLAN//Cl E- Kp, AALIDATIO•N CK. M.O. CASH
C 8 6 6:'e'o_J0N y 4A D 2 a?.0 0