HomeMy Public PortalAbout5020 AGNES AVE_Mechanical_5/15/1973_heater J - -a-
6A364
a—Z
6A3B4 - CEDE 8 - 3 69 IGATION FOR ERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FADDRESS
DEPARTMENT OF COUNTY ENGINEER � lv F BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER -e(it�COLEMAN W JENKINS SUPERINTENDENT OF BUILDING4
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) OWNER
MAIL 1
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS 5O LO eL
ABSORPTION SYSTEM BTU CITY LQ TEL NO
AIR HANDLING UNIT CFM CONTRACTOR S
BOILER HORSEPOWER ADDRESS
CITY TEL NO
COMPRESSOR HORSEPOWER STATE LIC
LICENSE NO CLASS
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER B
c �
FURNACE FAU GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER SUSPEND D UNIT
WALL tPt�2 3$?oc }
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NEW—ADDITION— PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $ S11,06,
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENT[
LATING AIR CONDITIONING APPROVALS D TE INSaTOR 5 GN TURE
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH a�
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE CALIFORNIA
SIGNATURE JACK R ALLEN SUPERVISING MECHANICAL
OF PERMITTEE
PERMIT VALIDATION CK M o CASH
PLAN CHECK VALIDATION
sEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE