HomeMy Public PortalAbout5728AGNES AVE_Mechanical 76A364E ICE t4 BA) 9/79
APPLICATIONFOG ERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS t ✓e�
LOCALITY t
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER �,J14Af
AIR HANDLING UNIT CFM MAIL -74ADDRESS
BOILER BTU CITYt TEL NO
,
COMPRESSOR BTU ,! !/ 4S
CONTRACTOR i�
VENTILATION SYSTEM ADDRESS ! All
EVAPORATIVE COOLER CITY TEL NO t41 SY 73
FURNACE FAU-GRAVITY STATELIC
FLOOR BTU LICENSE NO a y a CLASS (�
TE SUSPENDS UNIT- DISTRICT NO OUP (�VNE ESSED BY
WALL
INSPECTION RECORD
V
00
O
Plan check fee 25% of above
PERMIT ISSUING FEE$ Z
TOTAL EE —
PLAN CHEC LICANT
NAME
ADDRESS
s
CITY TEL NO
i
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 HEATI/ffi
NTILATING AIR f
CONDITIONING
I HEREBY CERTIFY T 41gT VIOLATIO F , APPROVALS DATE INSPECTORS 5I6N
CHAPTER 9 DIVISION OF HESSIONAL O E
OF THE STATE OF CAU ORNI� ROUGHAV
SIGNATURE FINAL I tet' �( (l
OF PERMITTE ( _ ) i
PLAN CHECK VALIDATION Mo CASH PERMIT VALIDATIONt cK n+o CASH
u
3 4 6,,c"-J JUL_ 3 4,1 0 X 2 7 0 E)