HomeMy Public PortalAbout6339 TEMPLE CITY BLVD_Mechanical__ T6A96AC ICE 01BA) I In6 APv"p CATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING33q N�
(PRINT OR TYPE ONLY) ADDRESS L
NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Lr-- Ciry
NEAREST
CROSS Sr N C)
ABSORPTION UNIT BTU ti0 LV rT O �%
OWNER U
AIR HANDLING UNIT CFM MAIL �y Q0.
ADDRESS IDl P VL.UP
BOILER BTU
cry
-7
4m x-L C—%-t TEL NO
COMPRESSOR BTU J d�
CONTRACTOR V.)
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CRY TEL NO
FURNACE FAU_GRAVITY STATE LIC
I FLOOR BTU D LICENSE NO CLASS
HEATER SUSPENDED—UNIT— DISTRICTNOQQ CROUP ZONE PROCESSED BY
WALL -L
R-z
INSPECTION RECORD 0
V
at
O
Plan check fee 25% of above
PERMIT ISSUING FEE; C.J'
TOTAL FEE MOO
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI5 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 I AM NOT ACTING IN VIOLATION OF APPROVALS DATE (NSP iOR 5 SIGNATURE
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL CODE 77
OF THE STATE OF CALIF NIA ROUGH
SIGNATURE FINAL
OF PERM ITTE
PLAN CHECK VALI cN mo CASH PERMIT VALIDATI N c® wo cA H
IF
1 0 59JUN 21 4 1 9 1 2.0 0A,56