HomeMy Public PortalAbout10554 DANBURY ST_Mechanical_11/17/1977_furnance C l
T6 A364 ACE 61R-I/T5
s APPLICA N FOR PER
HEATING VENTILATING - AIR C DITIONING
COUNTY OF LOS ANGELES BUILDING
/0�
DEPARTMENT OF COUNTY ENGINEER
4L 0*0�hLV-q
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) -
NO. TYPE&SIZE OF EQUIPMENT FEE MAIL //��
ADDRESS /tom
SEE BACK OF APPLICATION
CITY TEL. NO.
FORCE AIR FURNACE, BTU
CONTRACTOR S
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN
CITU T L. NO.
LIST ALL OTHERS BELOWSTATE �J S-1C)'L CLASS
LICENSE NO,
DISTRICT NO, GROUP 'ONE PR SSEO BY
INSPECTION RECORD
r
a
0
U
K
O
F
U
W
d
N
Plan check fee. See reverse. - ?
PERMIT LSSFING FF,P: S
01I'AL FEE 1 -7
PLAN CHECK APPLI NT
NAME J
ADDRESS
12
CITY EL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE l5 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, Al
R CONDITIONING.
ROUGH
HEREBY CERTIFY THAT AM NACTING IN VIOLATIO
OF CHAPTER 9, OIV1510 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OP THE STATE O ALIFOR NIA ! v
SIGNATURE y PERMIT VALIDATION cN. M.o. CASH
OF PERMITTEE ,q
PLA`NVC�dHP CFL. VP'CLQ(DDT�,IONt��4E�.I3� 'SH�C�FsN
1 9 8 NOV 17 4 1 0 1 53 5. e�i6
POLICY HOLDE,R: Mr ---
'OI_ICY 14LIMBER: yo 3 ysd ,Q