HomeMy Public PortalAbout4958 AGNES AVE_Mechanical_6/17/1969_Furnace 1
78A 364-CEBIB-B BB APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONOITIONIN
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
Ic
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY Al � G ! T
40 rzv
FOR APPLICANT TO FILL IN CROSS ST NEAREST
(Print or type only)
OWNER 46
NO TYPEJOF APPLIANCE OR EQUIPMENT FEE
MAIL
ADDRESS
ABSORPTION SYSTEM BTU CITY /i T 6 L
AIR HANDLING UNIT CFM CONTRACTOR 4 `
BOILER HORSEPOWER ADDRESS
COMPRESSOR HORSEPOWER CITY TEL NO
STATE LIC
VENTILATION SYSTEM LICENSE NO CLASS
DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE CO LER �•
FURNACE FAU A ITY 6O
FLOOR-B U INSPECTION RECORD f
HEATER SUSPENDED-UNIT—
WALL
USPENDED UNITWALL
9-
a
0
U
O
I'-
C-')
Lu
LNfl-
C")
Z
NEW—ADDITION— PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ Q
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 DATE INSPECTOR S SIGNATURE
LATING AIR CONDITIONING
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL s760 1.97r I�VZtr-0
CODE OF THE STATE AOFFO�RNIAJACK R ALLEN SUPERVIS CHANICAL ENG'R
OIF PERMIGNATUTTEE ' PERMIT VALIDATION CK M O CASH
PLAN CHECK VALIDATION
0 !D33":D- j174 "! D 7.0 n
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ��