HomeMy Public PortalAbout5029 TEMPLE CITY BLVD_Mechanical__ TeAleA-dela -Ino APPLICATION FOR PERMIT ✓
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING F
DEPARTMENT OF COUNTY ENGINEER ADDRESSId
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN IN JENKINS, SUPERINT¢NOENT OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO IT
YPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY TEL NO
ABSORPTION SYSTEM, BTU
CONTRACTOR N� F
AIR HANDLING UNIT, CFM
ADDRESS L b S��
BOILER HORSEPOWER CITY TEL NO3
COMPRESSOR HORSEPOWER ' STA LIC
LICENSE NO CL
VENTILATION SYSTEM DISTRICT NoSS
CLAS! n P NE PROCC !D ST
EVAPORATIVE COOLER ) ��
FURNACE FAU_GRAVITY INSPECTION RECORD
FLOOR BTU
HEATER SUSPENDED—UNIT
WALL
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NEW—ADDITION_ PERMIT $ 3 00 H
Z
ALTER—REPAIR— TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALS DAT[ INSR D SIGNATURE
LATINO AIR CONDITIONING
ROUGH
I HEREBY CERTIFY THAT I E NOT SS A90 IN VIOLATION
OF CHAPTER G DIVISION 3 OF THE BUSINESS AMO PROFESSIONAL FINAL
COD[ OF THE STAT[ 0 CALIFORNIA
SIGNATURE JACK R ALLEN,SUPERVISI CHANICAL ENG'R
OF PERMITTEE
PERMIT VALIDATION cN M o CASH
PLAN C K ALIDATION
0 3 1 05 0 Ams
SEE SACK OF APPLICATION FOR COMPLETE PEE DCH[OUL[