HomeMy Public PortalAbout4940 BALDWIN AVE_Mechanical__ (3) 76A364 - CE818 - 3 69 APPLICATION FOR PERMI
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FAU
DING
DEPARTMENT OF COUNTY ENGINEER ESS
JOHN AING AND LAMBIESAFETY COUNTY ENVISION
GINEER LITYCOLEMAN W JENKINS SUPERINTENDENT OF BUILDINGEST �yS ST 36Cy
FOR APPLICANT TO FILL IN OWNER/
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS - 7
ABSORPTION SYSTEM BTU CITY TEL NO\7� o ya7
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AIR HANDLING UNIT CFM
CONTRACTOR /D Q/V dS
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/ ADDRESS//3 J
BOILER HORSEPOW D
CITY /l1/ TEL NO �3p2 ao� Q
COMPRESSOR HORSEPOWER STATE 3r��1 p-s'5 /
LICENSE NO ✓oCOCLASS qL�(O
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER �j` O
FURNACE FAU GRAVITY s� v 111 1 _lam
INS ECTION RECORD
FLOOR BTU
HEATER SUSPENDED UNIT
WALL
O
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CL
N
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NEW—ADDITION— PERMIT $ 3 00
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
IHEREBY 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
LATING AIR CONDITIONING APPROVALS DATE INSPECTOR S SIGNATURE
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINALp�
CODE OF STATE OF CALIFORNIA
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JACK R ALLEN SUPERVISING MECHANICAL ENG R
PERMIT VALIDATION CK M 0 CASH
PLAN C CK VALIDATION
0.50E 4,9 6 -9' Uftx 15 4 1 D' 10.50-
E
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