HomeMy Public PortalAbout8616 WORTHINGTON DR - Mechanical - 1973-03-14 70�A564 - CE BIB - 9-" APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS 8616 Worthington DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY San Gabriel
NEAREST
CROSS ST. Burden
FOR APPLICANT TO FILL IN OWNER Otto BlOah
(PRINT OR TYPE ONLY)
MAI L
NO. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS
8616 Worthington
CITYSan Gabriel TEL. NO. _
ABSORPTION UNIT, BTU
CONTRACTOR AQUa.t• P
AIR HANDLING UNIT, CFM
ADDRESS101 E Huntington Drive
BOILER, BTU CITY Arcadia. TEL. NO. 4".4661
COMPRESSOR, BTU STATE LIC.
LICENSE NO. 6 CLASS C—
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE SSED BY
EVAPORATIVE COOLER •�— , o}
FURNACE: FAU_GRAVITY O
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED—UNIT—
WALL
USPENDED UNIT_WALL v
CL.
s D gv o •
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 3 00
TOTAL FEE v d
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CO ING.
ROUGH
I HERE Y CERTIFY HAT I A NOT AC IN VIOLATION �e{
OF CHAPTER DIV .N OF THE USI NES ND L FINALj�.{•�-g�y, �
CODE OF THE ST OF LIFORNIA.
SIGNATURE PERMIT VALID TIONCK. M.O. CASH
OF PERMIT
PLAN CHECK VALIDATfON CK. M.0. CASH
954573 MAR 1441q 10.510 tri
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE