HomeMy Public PortalAbout4931 AGNES AVE_Mechanical_8/24/1972_ 76 A364 - CE 818 - 9 71 APPLICATION FOR PERMI
` f 6 HEATING'- VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPEOFAPPLIANCE OR EQUIPMENT FEE ADDRESS
CITY e TEL NO ,
ABSORPTION UNIT BTU
CONTRACTOR �
AIR HANDLING UNIT CFM
ADDRESS W3 L
BOILER BTU CITY EL NO_'2� `� ro
COMPRESSOR BTU _�v� STATE LIC
LICENSE NO .� CLASS
VENTILATION SYSTEM DISTRICT NO GR0, ONE PROCE ED BY
EVAPORATIVE COOLER J I 0� �` ( d
FURNACE FAU-AL"G VITA' Q t
FLOOR BTU INSPECTION RECORD
HEATER SUSPENDED UNIT_ O
F-
WALL C.�
LLA
o..
N
. _ Z
Plan check fee 25% of above See reverse
PERiNIP1 ISSUING F LE $ 3 00
TOTAL FEL i
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
r
LNDA BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
E THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ORDINANCES AND LAWS REGULATING HEATING VENTI APPROVALS DATE
ECTORS ANORE
IR CONDITIONING r
ROUGH
EBY CERTIFY HAT I AM NOT AC G IN VIOLATION
ER 9 DTVI N 3 0 HE BUSINE D ROFESSI NAL FINAL
THE STAT0URE PERMIT VALID T N CK M 0 CASH
MITT
t
PLAN CHECK VALIDATION CK M 0 CASH
X 7 7 1-?-- -AUG 24 4 1 D 13.00-
SEE
3.00-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE