HomeMy WebLinkAbout1597A I ' �
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76A364C
CE-Bt8(REV.11/78)
�as APPLItAT10N FOR PFRMIT
HEATING - YENTIIATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING��� 3 �`��,� /1,��
(PRINT OR TYPE ONLY) ADDRESS /"S�
LOCALITY ��
NO. TYPE OF APPLIANCE OR EOUIPMENT FEE
NEAREST �j��/�y �
CROSS ST. l���G�
ABSORPTION UNIT,8TU
OWNER
AIR HANDLING UNIT,CFM MAIL /
! BOILER,BTU (���W V p ADDRESS � �'�L`i"
CITY � TEL.NO.`�F°'l�:!VC,/
/r/�r /
COMPRESSOR,BTU CONTRACTOR �/J��O
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VENTILATION SYSTEM �����/
ADDRESS �O
EVAPORATIVE COOLER
CITY TEL.NO.� ��
FURNACE: FAU GRAVITY STATE /�/)�; � LIG. �'�
FLOOR BTU LICENSE NO. ��« CLASS
HEATER: SUSPENDED UNIT_
WALL APPRDUALS DATE INSPECTOR'S SIGNATURE
ROUGH
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d
FiNAI f�' � 0
V
INSPECTlON RECOR pp
0
Plan check fee 25%of above. �
PERMIT ISSUING FEE� c�lJ
� �
T07A1 FEE �'�'J
PLAN GHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRE55
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 LAWS REGULATING HEATING. VENTILATING. AIR z 1 5 9.7 A
coNoirioNiNc. PERMIT VALIDATION
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIO�ATION OF '�i � � � ��;1
CHAPTER 9, DIVIStON 3, f THE BUSIN� PROFESSIONAL CODE j�•
OF THE STATE OF CALIF 'IA. B ,I • • 1 +�G G
SIGNATURE �•GV
OF PERMITTEE
DISTRICT NO PROCESSED Y ,r�� � � ��O��-
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