HomeMy Public PortalAbout5118 AGNES AVE_Mechanical_8/18/2003 76A364-CE818-9 68 APPLICATION FOR PERMIT
• - HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 5�I0 A A/
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY -- p
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
(Print or type only)
OWNER A/ f.V
NO TYPEJOFAPPLIANCE OR EQUIPMENT FEE
MAI L
ADDRESS
ABSORPTION SYSTEM BTU CITY TEL NO
AIR HANDLING UNIT CFM CONTRACTOR 7'�` �p� 1y
BOILER HORSEPOWER ADDRESS �eL r
COMPRESSOR HORSEPOWER CITY TEL NO
STATE LIC
VENTILATION SYSTEM LICENSE NO CLASS lr "
DISTRICT NO GROUP ON PROCESSED BY
EVAPORATIVE COOLER v� o
FURNACE FAU GRAVITY / c J ZUU
FLOOR—BTU INSPECTION RECORD
HEATER SUSPENDED—UNIT-
WALL
USPENDED UNITWALL
9-
/` t
^j ,(
w
a
Z
NEW—ADDITION— PERMFT $ 3 00
ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
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 VENTI APPROVALS ZIA4 S CTORS JOOATURE
LATING AIR CONDITIO
ROUGH
I HEREBY CERT] Y AT I A OT ACTING IN VIOLATION FINALi.. '' °
OF CHAPTER 9 DIVISI 3 OF TH B SINESS AND PROFESSIONAL
CODE OF THE STATE CALIFORNt JACK R ALLEN SUPERVI=KM
HANICAL ENG R
SIGNATURE
OF PERMITT PERMIT VALIDATIO O CASH
PLAN CHEC ' LIDATION
I An, 9 4 5 0 Af'R� 4 2 D � C �~
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE