HomeMy Public PortalAbout6053 AGNES AVE_Mechanical__ 70A364—CER19-8 68 APPLICATION FOR PERMIT - n
HEATING - VENTILATING - AIR CONDITIONIN lul
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITYNEAREST
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FOR APPLICANT TO FILL IN CROSS ST - (�JLLra2�G
(Print or type only)
OWNER
NO TYPEJOFAPPLIANCE OR EQUIPMENT FEE
MAIL
ADDRESS 605
ABSORPTION SYSTEM BTU CITY TEL NO,942 3
AIR HANDLING UNIT CFM CONTRACTORe
BOILER HORSEPOWER ADDRESS
COMPRESSOR HORSEPOWER CITY TEL NO
STATE LIC
VENTILATION SYSTEM 00 LICENSE NO CLASS
DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE FAU GRAVITY i0 r —
FLOOR—BTU INSPECTION RECORD
HEATER SUSPENDED—UNIT-
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USPENDED UNITWALL
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NEW- ADDITION— PERMIT $ 3 00
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ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
LLATING
Tel No
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 ATE I PECTOR SIGNATURE
IR CONDITIONINGROUGH
EBY CERTIFY THAT I AM NOT ACTING IN VIOLATION FINAL UER 9 DIVISION 3 OF THE BUSINE AND ESSIONALHE STA CALIFORNIA (/ JACK R ALLEN SUPERVISI CHANICAL ENG R
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RNA ,ITT �'G(J PERMIT VALIDATION CK M O CASH
PLAN CHECK VALIDATION
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE A /
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