HomeMy Public PortalAbout6411 TEMPLE CITY BLVD_Mechanical__ TB A36{- CE 818- 5J3
APPLICATION FOR PERMIT
A HEATING - VENTILATING - AIR CONDITIONING �!
COUNTY OF LOS ANGELES ADDRESS 4
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY Q
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NEAREST
CROSS ST (J )
FOR APPLICANT TO FILL IN OWNER e e e
(PRINT OR TYPE ONLY)
MAIL "J
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS fJ J
CITY Q TEL NO G
ABSORPTION UNIT, BTU
CONTRACTOR O
AIR HANDLING UNIT CFM
ADDRESS
BOILER, BTU CITY TEL NO
COMPRESSOR, BTU STATE LI
LICENSE NO CL
VENTILATION SYSTEM RIOT No GRGUP z Ne Roc E!!!D BY
EVAPORATIVE COOLER I J)
FURNACE FAUGVLT7
FLOOR BTU vv INSPECTION RECORD
HEATER SUSPENDED—UNIT_
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Phn chrcV. fee 25% 0( ibo%e See rc,ene
PCRMI I ISSUING FEF S a 00
OTAL 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 AGREE TO COMPLY
WITH ALL ORDINANCES AND LAW! REGDLATING HEATING VENTI APPROVAL! DAT! 1Nl PECTOR'!SIGNATURE
LATING AIR CONDITIONING
RO UG H
I HERCBY CERTIiY TN I NOT AC ENO IN VIOLATION ,
OF CHAPTER G DIVISION a F T B11l INE RD PROFESSIONAL FINAL ���-
CODE OF THE STATE OF CA OR
SIGNATURE P RMIT VALIDATION CK M 0 CASH
OF PERMITTEE
1
PLAN CHECK 711ATION CK M 0 CASH
523" AP 441 U 8.00
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE