HomeMy Public PortalAbout6320 TEMPLE CITY BLVD_Mechanical__ TB A 36 - CEO 15- B-73
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS oZO L T� LJb
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY /� / �(Q k
NFE RESTL
CROSSST mGuEfA
FOR APPLICANT TO FILL IN OWNER ED rr�/r1
(PRINT OR TYPE ONLY) �^� �� I GS
NO YPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS 14.1r, N ARA" p
ABSORPTION UNIT BTU CITYCONTRACTOR S SAN GANWBrR� IATIEITEL NO S -3, 03
AIR HANDLING UNIT, CFM �-
ADDRESS
BOILER, BTU CITYL STATE /SQA' /I ] TEL NO 3311-03� a
COMPRESSOR BTU / LIC
LICENSE NO pLJ SIJ CLASS � dO
VENTILATION SYSTEMDISTRICT NO anoU / ,^z/oNE OC ED BY
EVAPORATIVE COOLER — 1 K_
FURNACE FAU_G VIT O
FLOOR INSPECTION RECORD
BTU
HEATER SUSPENDED—UNIT—
WALL
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Plan check (Be 25% of IboTe See reNcr+e z
PF HNIII ISSIJI\G FFF S 00
101 kL FEF
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AOREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALS DATE INS TORS SIGNATURE
LATING AIR CONDITIONING
ROUGH /6'7
I HERESY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL -
CODE OF THE STATE 0 LIFORNIAO
SIGNATURE PERMIT VALIDATION �•N M D CASH
OF PERMITTEE
PLAN CHECK VALIDATIOAIINISs CASH
242�AUG 1041 0 27.00
POIJrY l-►OLDER: - - - -
POLIfY NUMBER: y7s6yf- 77
SEE BACK OF APPLICATION FOR COMPLETE FEE SCNEOULE /G i 1-�1