HomeMy Public PortalAbout5921 TEMPLE CITY BLVD_Mechanical__ 76A364--CEBi a'-1/70 1 -�� ��
APPLICATION FOR ERMIT �i
HEATING - VENTILATING;- AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY lee
JOHN A. LAMBIE. COUNTY ENGINEER' NEAREST '
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGIMAIL
CROSS ST.
FOR APPLICANT TO FILL IN OWNER '
(PRINT OR TYPE ONLY)
NO. TYPEOFAPPLIANCE,OR EQUIPMENT F,EE ADDRESS
CITY TEL. NO.
ABSORPTION SYSTEM, BTU
CONTRACTOR `
AIR HANDLING UNIT, CFMof z
ADDRESS
i
BOILER, HORSEPOWER q� CITY TEL. NO.
COMPRESSOR, HORSEPOWER—�,� STATE LIC. CO �.
LICENSE NO. CLASS LJ
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE OCESSED BY
EVAPORATIVE COOLER
FURNACE: FAU_GRAVI Y INSPECTION RECORD
FLOOR
HEATER: SUSPENDED—UNIT—
WALL
USPENDED UNIT_WALL
c
- z A. c
C
c
c
L
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NEW—ADDITION— PERMIT $ 3 00 j s
ALTER—
REPAIR— TOTAL FEE $ IPiuh t -
PLAN CHECK APPLICANT dlJ
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 'N IECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
I HEREBY CERTIFY THAT I AAA NOT ACTINO IN VIOLATION ROUGH
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINALVL 94
CODE OF THE STATE OF FORNI
SIGNATURE
JACK R. ALLEN,SUP IN ECHANICAL ENG'R.
PERMIT VALIDA CK. M.O. CASH
PLAN CHECK VALIDATION V
LAL;o F ° 7 1 MAY 9 4 1 D 1 8,0 0-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -