HomeMy Public PortalAbout5476 TEMPLE CITY BLVD_Mechanical__ 6
•75 A354 CE BIB- 5-73
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
f
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY —e
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) P
MAIL
NO YPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY � EL NO
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS qqq
BOILER BTU CITY TEL '
COMPRESSOR, BTUSTATE �p LIC
LICENSE NO ^�JO CLASS
VENTILATION SYSTEM DISTRICT NO 61 ouP ZONEk--PE!BED BY
EVAPORATIVE COO R
FURNACE FAU GR VITY OU INSPECTIONNN RE CO RD
FLOOR BTU
HEATER SUSPENDED—UNIT—
WALL
c�
z
0
W
d
N
Plin rherh fee 2i4 of IbGTc Lce re,r.e
PI.H\llI ISSIII\C PFI, S 3 00
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND !TATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCE! AND LAW! REGULATING HEATING VENTI- APPROVALS DATE INSPECTORS SIGNATURE
LATING AIR CONDITIONING
ROUGH
HEREBY CERT I HAT ♦M N T ACTING IN VIOLATION
OF CHAPTER 99DI IGH T B INES! AND CRO ESSIONAL FINAL
CODE OF THE LE OI I
SIGNATURE !/1 PERMIT VALIDATION CK M G CASH
OF PERMITTE
PLAN CHECK ALIDATION M D CASH /
9 4 1 0 1 3.0 0 A�10
SEE SACK OF APPLICATION FOR COMPLETE FEE SCHEWLE `