HomeMy Public PortalAbout5738 AGNES AVE_Mechanical_2/24/1971_ 78 +-.CE81 ' '° APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING !3
DEPARTMENT OF COUNTY ENGINEER ADDRESS :JCS4GNM
V
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER ITU RE
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST ,!
CROSS ST. C) F
FOR APPLICANT'TO FILL IN OWNER L
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEDR EQUIPMENT FEE ADDRESS
CIT TEL. NO.
ABSORPTION SYSTEM, BTU RX CiT-1
CONTRACTOR (I S
AIR HANDLING UNIT, CFM �6+
ADDRESS Q[ � g
BOILER, HORSEPOWER CIT TEL. NOaj?5_7,q
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. �'- CLASS
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE: FAU G AVI Y INSPECTION RECORD
FLOOR BTU JK
HEATER: .SUSPENDED UNIT_
WALL
a
c
a
c
u
a
v
NEW —ADDITION— PERMIT $ 3 00 ?
ALTER—REPAIR— TOTAL FEE $
PLAN CHECK APPLICANT
NAME WI'IUS
ADDRESS
ry7 a
CITY � 01 \ � 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 HEAi
NG, VENTI- APPROVALS DATE I PECTOR'SS NATURE
EATING, AIR CONDITIONING.
ROUGH 7f
I HEREBY CERTIFY THAT AM A TING VIOLATION-0F CNAPTER 9, DIVIS N3, E SINES AND PFESSIONAL FINAL 14�'
CODE OF THE STATE F A. /,.
SIGNATURE JACK R. ALLEN,SUP RVISING MECHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION M.O. CASH
PLAN CHECK VALIDA ION
__ Ci ? 4 FS 7 4 4 1 d 7.0 0
C/
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE