HomeMy Public PortalAbout10234 RANDWICK DR_Mechanical__ 7GA3642a- C611118S.9/75 . APPLICATION FOR PERMIT
` HEATING - VENTILATING -dAIR
BUILDI GFND SAFETY DI ION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
10234 Randwick Drive
LOCALITY TeMl2le City
NO. TYPE OFAPPLI'ANCEOR EQUIPMENT FEE NEAREST
CROSS ST.
Green St-
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU CITY Temple - It TEL. NO. s7s_$
' 1 COMPRESSOR, BTU__30-000 50 1 CONTRACTOR
VENTILATION SYSTEM ADDRESS 166 W
. Live Oak Ave-
EVAPORATIVE COOLER CITY Arcadia TEL. NO. 446-6118
FURNACE: FAUX_GR VITY STATE LIC.
FLOOR BTU O p LICENSE NO. 20228 CLASS
�-
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ONE OCESSED BY �-
_ O
WALL O� �� C
F--
/' INSPECTION RECORD Lvu
1/12- C; L LC-b /�' /✓or rc7��C'
` Plan check fee 25%of above.
PERMIT ISSUING FEE $ 4 5pLC �G/r?�1
TOTAL FEE 19 50 e7
PLAN CHECK APPLICANT
6(4/Netl �p�v/mac lM 11v/e1IV UA11,e
NAME 7—d
am- / 'i i-lft U Ir r IAI' hUr/5/� C .
ADDRESS I/ dI- RO tCall�/ - 0-//e-/,7 I 200121 (1(1 L
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TEL.NO, fffli -Alrtt;S/O EJ .G' lG�✓8HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-G, AIR CONDITIONING.HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE I i INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE 0 CALIFORNIA. ROUGH
SIGNATURE �r FINAL
OF PERMITTEE
PERMIT VALIDATION
PLAN CHECK VALIDATION CK. M.O. CASH M.O. CASH
{6 5 9-SEP 7 4.1 0 19.5 a t-�n
M '-D __ I
BA364-CxBI6-B-68 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONIN
COUNTY OF LOS ANGELES
DEPARTMENT'OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER :OZ5 d2
ST
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS ST.
(Print or type only)
OWNER
No. TYPEIOF APPLIANCE OR EQUIPMENT FEE
MAIL
ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL. NO.
' AIR HANDLING UNIT, CFM�/ CONTRACTOR
BOILER, HORSEPOWER ADDRESS s%
� s
COMPRESSOR, HORSEPOWER CITY 11f0. NO. _5zwp
STATE
VENTILATION SYSTEM LICE SE:NO. �- CLASS Atle
DISTRICT NO. GROUP ZONE PROCESS D BY
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY
FLOOR—BTU IjfPECTr0N REO RD
HEATER: SUSPENDED—UNIT-
WALL
USPENDED UNITWALL at
O
C>
O
F—
U
W
y
z
NEW—ADDITION— PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
City Tel. No.
1 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- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
ROUGH
ICH
HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL ' FINAL ��3-7D jhi.4v_r
CODE OF THE STATE OF CALIFORNIA. JACK R. ALLEN,SUPERVISIN CHANI CAL ENG-R.
SIGNATURE r
OF PERMITTEE PERMIT VALIDATIO CK. M.O. CASH
PLAN CHECK VALIDATION
r. C 112 9 JUL 2 4 4 1 0 1 0 5';EE BACK BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
1