HomeMy Public PortalAbout5921 AVON AVE_Mechanical_9/14/1977_furnance 76A364EICE-81SA)-11/76 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -1 Z n /' Q, �.rl �/'i�l }
• BUILDING AND SAFETY DIVISION, V � 1✓
FOR APPLICANT TO FILL IN BUILDING. .
(PRINT OR TYPE ONLY) ''I ADDRESS-' - 'Q-
(
. NO. -TYPE OF APPLIANCE OR EQUIPMENT FEE' LOCALITY
.NEAREST
/� 2S
CROSS ST. `
ABSORPTION UNIT,BTU / \nIT
- OWNER t- •�
AIR HANDLING UNIT,CFM f MAIL, n/{ V
ADDRESS/ � l
BOILER,BTU CITY 1 TEL.1\ - {
COMPRESSOR,BTU CONTRACT, R
VENTILATION SYSTEM - ADDRESS' v
'EVAPORATIVE COOLER CITY ,,�' TEL.NO.
FURNACE: FAU_GRAVITY, STATE ' LIC.
FLOOR. - BTU LICENSE NO �VZ. - CLASS -
EATER:' SUSPENDED UNIT- DISTRIC�T•NO. GROUP 11141fSEPROCESSED BY
WALL //- . / `�
INSPECTION RECORD
O
pm
Plan check fee 25% of above. U
PERMIT ISSUING FEE
TOTAL FEE
a
PLAN CHECK APPLICANT
NAME ,
ADDRESS
CITY s TEL.NO. s
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, VENTILATING, AIR
CONDITIONING.
I HEREBYCERTIFY THAT I AM NOT ACTING IN VIOLATION OF, APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE ROUGH -
OF THE STATE OF CAL,- RNIA.
SIGNATURE FINAL
OF PERMITTEI ,
PLAN CHEC ALIDATION p cii. M.`O. CASH' PERMIT VALIDATI CK. M.O. cnsH
.r -