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HomeMy WebLinkAbout1537A � 76A�64C CE-81B(REV.11/7B) ��s APPLICATION FOR PERMIT • NEATING - VENTIIATING -�AIR CONDITIONING . , � , . COUNTY OF LOS ANGELES ' BUILDING AND SAFETY FOR APPLICANTTO FILL IN HU�LDING ADDFtES:a �� IPRINT OR iYPE O'�LY) LOCALITY t r NO. TYPE OF AAFLIANCE OR EOUIFh1Ef�T FEE �v NFARE:aT GRO55 ST. A�SORPTION UNIT,�TU ONJNER � LI � l J AIR HANDLI C;UhIT,CFM qpDRE55 J O �(7F( � � ��Q BOIIER E�T G�+� V D 0 cirr I�f( i � .�9�- i COMPRES.�iOR,BTU CONTRACTOfi — � VENTILATION SYSTEN • ADDFiES.i EVAPORATIVE COOLCR CITY TEL.NO. FURNACC: FAU_GRAVITY �TATE • LIC. �' FLOOR �TU LICENS[:IVO � GlAS:'i O HEATER: SUSPEN�ED UNIT� A�VpO'JRlS D4TE iv�e[C70q'SS�G'.aTu7E U YJALL � � FOUGFI '� �f�/( /- �• O i' F^ FI�:AL U W INSP T HECORD d W . ` � Plan check fee 25°0 of above. PERMIT ISSUING FEE; � TOTAL FEE C�% PLANCHECKAPPLICANT PLAN CHECK VALIDATION NAME /� : � �r'. .i �/� ADDRESS !.`� • • • (: � CITY, TEL-NO. � .� • • C7.n�i 1 HCFEDY ACK�O�L'LECGE iHAT I HA�.READ iH15 APPLICATION AtiD STATE�THAT THE A�30VF,,,15 CORRCCT A J AGREE TO 0.'.1PLY 1SITH ALL 7 ORDI�AhCES AND ��'h' FECULATI4� Fi:ATItiG, cNTI�ATI':G. AIR r � .� i�l',r•(j� conoiriovitic. n '� PERMIT VALIDATION [ I HEP.EDY ERTIF INAT � A �'OT AfTI. � IV VIOLATIO.': CF C I�C��C� O CHAPTCR 9. D ISIOK p� TF1Ej015i .�.,�S,aS'J ROFE5510tiAL C00[ OF TIIE 5T.1TE )F CFLI OPltiln• / � �� SIGNATURE �� � �, ( OPPEr�11TTCE � � y 71SiRIC1 h0 . / ' �ROC S?D Or 4� o� -��-���� � �t�b � `�� . f�� �.� ��� • . � . � • . , ; , . ', . ' � . .� ' ' - .. .. • .. �•.. : � � , ^. � . .. � ' , , � . � . .. ' t•. /��