HomeMy Public PortalAbout5721 OAK AVE_HVAC_7/9/1973_Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 3. 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME William J. 10 Dykes
ADDRESS 5721 NO. Oak Ave., 1.
CITY m_.,T7i -. na r TEL.No285-2468
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AMD P ERS( AL
CODE OF THE ST F CALIFON
SIGNATURE S•_ -
SI PERMITT y«'F-f-Jil
u
ALAN CHECK VALIDATION c M.G. casesO
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
APPROVALS DATE 14, ECTOR'B GNATURE
ROUGH
FINAL
PERMIT V�A4LI,TION cK M.O. CASH
TO A36r
CE BIR - 9-71
APP CATION FO PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
ING
BUILADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
r 5, 7l
p wo nak �Tqmple City -
LOCALITY A�
NEAREST Live
CROSS ST.
FOR APPLICANT TO FILL IN
(OWNER
(PRINT OR TYPE ONLY)
IJi-11imm .T- TVI«o
NO.
TYPEOFAPPLIANCEOR EQUIPMENT
FEE I
MAIL
ADDRESS as above
II
CITY Temple City TEL. NO. 285-2468
ABSORPTION UNIT, BTU
AIR HANDLING UNIT, CFM 16110
CONTRACTOR 6;e
ADDRESS
BOILER, BTI(
CITY TEL. NO. -
i
COMPRESSOR, BTU&'COV
I STATE LIC.
LICENSE NO, CLASS
VENTILATION SYSTEM
DISTRICT NO.
GROUP zONE
P BRED BY
EVAPORATIVE COOLER
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FURNACE: FAU�2L GRAVITY
FLOOR BTI( AVI aoO
INKS PECTIO REC D i
/S (M /
o
HEATER: WUASPENDED_UNIT_
I.
71Y61'7 -5
w
I
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 3. 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME William J. 10 Dykes
ADDRESS 5721 NO. Oak Ave., 1.
CITY m_.,T7i -. na r TEL.No285-2468
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AMD P ERS( AL
CODE OF THE ST F CALIFON
SIGNATURE S•_ -
SI PERMITT y«'F-f-Jil
u
ALAN CHECK VALIDATION c M.G. casesO
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
APPROVALS DATE 14, ECTOR'B GNATURE
ROUGH
FINAL
PERMIT V�A4LI,TION cK M.O. CASH
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