HomeMy WebLinkAbout1374A �
76A364C
CE-818(REV.11/76)
cs APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES� ��f��7 BUILDING AND SAFETY .�- c�
BUILDING ���� ��Q�
FOR APPLIGANT TO FILL IN ADDRESS +�'+ • �
� (PRWT OR TYPE ONLY)
� � LOCALITY �
NO. TYPE OF APPLIANGE OR EQUIPMENT� . . FEE �
NEAF2EST r /�� , /�Q_ �
� - � CROSS ST. � E�? �'V r7
ABSORPTION UNIT,BTU i.s
OWNER �
AIR H�ANDLING UNIT,CFM MAIL �
ADDRESS
BOILER,BTU CITY//1 TEL.NO. _
�... $Q w
COMPRESSOR,BTU .�-3�oaa (} '' CONTRACTOR 4I�
VENTILATION SYSTEM ADDRESS f�
r
EVAPORATIVE COOLER � CITY TEL.NO ����C1 �
FURNACE: FA R VITY STATE LIC. �� �
FLOOR BTU � _ LICENSENO Q GLASS r�
HEATER: SUSPENDED UNIT_ APpROVALS D INSPE R' SIGNATURE �
WALL �
_ ROUGH � - �D
M—
. . F�IN � . - - . ,�.�-�
IN ECTION R CORD ,�j
�
Plan check fee 25% of above.
PERMIT ISSUING FEE$ 'T "'`
TOTA�FEE
P�arv cHecK aPPucaNT PL�AN CHECK VALIDATION
NAME � W t l� ✓ ��` '� C r��
ADDRESS ���,�c�: " . _
c_. E u !� _ ��,
CITY TEL.NO. � -
n � m � �
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPCICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL `�+ = =- C-� :�`!.'
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
coN�iTioNiNc. PERMIT VALIDATION � . - --
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF �
CHAPTER��9, DNI � 3, OF THE BUSINESS AND PROFESSIONAL COOE ;. �L_ �. 4�-e„� r-,
OF THE STATE O � ORNIA. � `� �- '—
SIGNATURE
OF PERM IT - -
DISTRICT NO. ' PROCES,ED BY
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