HomeMy Public PortalAbout5957 TEMPLE CITY BLVD_Mechanical__ 76A3r(f4E:ICE,•816M-11/78 APPLICATION FOR PERMIT
HEATING - TILATING - AIR �IDITIONING
COUNTY eF OS ANGELES G
DEPARTMENT OF COUNTY ENGINLzER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN F
DING
(PRINT OR TYPE ONLY) RESSA.ALITY eNO. TYPE OF APPLIANCE OR EQUIPMENT FEERESTSS ST, yL
ABSORPTION UNIT.BTU
OWNER W eVt, ry" Ci-
AIR
AIR HANDLING UNIT,CFM MAIL ,
44
ADDRESS 10 Z Ir ero
BOILER.BTU
CITY ;•r W TEL.NO.
COMPRESSOR,BTU Y CONTRACTOR
VENTILATION SYSTEM ADDRESS
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EVAPORATIVE COOLER CITY Q TEL.NO. S' / 0/1?
FURNACE: FAU GR VITY• STATE /� / LIC. �a
3 FLOOR BTU LICENSE NO. /. 2 CLASS
HEATER: SUSPENDED UNIT- DISTRICT NO. GROUP ZONE �2SSED BY
WALL
INSPECTION RECORD
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Plan check fee 25%of above. ri
IL
PERMIT ISSUING FEE$
TOTAL FEE — —
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE ROUGH
OF THE STATE OF CALIFORNIA. /
SIGNATUREjQ/� ///J9d f/ an.
OFPERMITTE�,rc/Jt`le fil�CX/,c/ FINAL
PLAN CHECK VALIDATION CK: M.O. CASH PERMIT VALIDATION cK M.O. CASH
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8 6 .9.=JUL 24 4 1 02 7.0 0 Arid