HomeMy Public PortalAbout5218 AGNES AVE_Mechanical_11/13/1974 76 A364!CE 819- 5-73
APPLIVATION FOR PE MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY TEL NO
ABSORPTION UNIT BTU
CONTRACTO G
AIR HANDLING UNIT CFM
ADDRESS
f
BOILER BTUAor CITY NO�
COMPRESSOR BTU STATE LIC
LICENSE NOxC/ CLASS
VENTILATION SYSTEM DISTRICT NO OUP ZONE CESSED BY
EVAPORATIVE COOLER n i�
� V
FURNACE FAUGRAVITY
FLOOR BTU INSPECTION RECORD
HEATER SUSPENDED-UNIT-
WALL
USPENDED UNIT_WALL
0:
d
O
U
O
H
U
W
N
Plan check fee 255. of above See reverse z
PERMI I ISSUING FLP S 3 00
TOTAL FEC ('
PLAN CHECK APPLICANT
NAME
ADDRESS
s
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 DATE INSPECTOR S SIGNATURE
LATING AIR CONDITIONING
ROJGH
I HEREBY E NOT ACTING IN VIOLATION
OF CHAPTER 9 OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF TH ATE IFORNIA I
SIGNAT E PERMIT VALIDATION (::j M O CASH
OF PE ITTEE
PLAN CHECK VALIDATI CK M O CASH
609CZNOV 441 D 1050 ®z,-o
n
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE