HomeMy Public PortalAbout5938 ROSEMEAD BLVD_Mechanical__ 5
° TEMPLE CITY
76 A354- CE 81x'8-1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY-OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR•'APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAI L
NO. TYPE&SIZE OF EQUIPMENT ADDRESS aboVe
SEE BACK OF APPLICATION
FORCE AIR FURNACE, BTU CITY Temple City TEL. 285-9407
CONTRAC
COMPRESSOR, BTU � /�J�1
ADDRESS
2034 N. park gd
;.
VENTILATION FAN CITY TEL.
S_ F1 Mnntp
LIST ALL OTHERS BELOW LICE STATE
R0094 CL%s20
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DISTRICT NO. GROUP ZONE PRO SSED BY
� 1 '
INSPECTION RECORD
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Plan check fee. See reverse. Sb z
PI:R\IIT ItiS1:1\C FEES
TOTAI. FEE:
PLAN CHECK APPLICANTAo
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- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION _
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF CA FORN
SIGNATURE -PERMIT VALIDATION cK. M.0. CASH
OF PERMITTE
PLAN CHECK VALIDATION CK, M.O. CASH
877N.rAN 2741 ' 19.50A-98