HomeMy Public PortalAbout9059 ACASO DR_Mechanical_8/31/1972 76A 19 - 3-69 APPLICATION FOR PER T
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HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF'LOS ANGELES FU
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION /J
JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS,SUPERINTENDENT OF BUILDING
FOR APPLICANT TO FILL IA OWNER Q®`�
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY K-- fLg TEL NO
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS I l�
BOILER, HORSEPOWER
CITY , TEL NO
COMPRESSOR, HORSEPOWER STATE LIC
LICENSE NO + CLAS
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROC SSED BY
® � /
� EVAPORATIVE COOLER JJ c
FURNACE FAU GRAVITY
FLOOR BTU oQ INSPECTION RECORD
HEATER SUSPENDED UNIT
WALL CL
C
U
Q
H
U
w
CL
Ln
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NEVIIdggWBDITION_ PERMIT $ 3 00
ALTER- REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME A to b` Lk&G a
ADDRESS = .-
CITYPL r 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 D TE 1 ECTOR'IS S GNItTURE
LATING AIR CONDITIONING • ji
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH ,
CHAPTER 9, DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL '
CODE OF THE STATE F LI RNI
SIGNATURE �� JACK R ALLE , S PERV CHANICAL ENG'R +
OF PERMITTEE 'G
PERMIT VALIDAT cls M 0 CASH
PLAN CHECK VALIDATION
Jim " a 5 2 N AUG 31 4 1 8.0,0-
tv-E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
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