HomeMy Public PortalAbout5817AGNES AVE_Mechanical r0l*36-77
76A364-CE818-1 68 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FENTGJOHN A LAMBIE COUNTY ENGINEER COLEMANW JENKINS SUPERINTENDENT OF BUILDING nn�G� /7, / �,! `AS!FOR APPLICANT TO FILL IN CA,V
(Print or type only)
OWNER 4/V a,D
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
MAIL
ADDRESS
ABSORPTION SYSTEM BTU CITY TEL 7�1
AIR HANDLING UNIT CFM CONTRACTOR �I\/� 16 A /l [� 1 T
BOIL E R EPOWER s ADDRESS �� /S ,4 �;7 V
COMPRESSOR HORSEPOWER CITY ��(��111A TEL NO
STATE
LIC
VENTILATION SYSTEM LICENSE NO, CLASS
CLASS
DISTRICT NO GROUP ZONE PROCESS50 BY
EVAPORATIVE COOLER X�+/
FURNACE FAU GRAVITY DV / CL
FLOOR—BTU INSPECTION RECORD v
HEATER SUSPENDED UNIT w
WALL p
F-
U
W
O-
Z
NEW—ADDITION— PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ Q _11-0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
HEATING VENTILATING AIR CONDITIONING
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL
CODE OF T STATE OF CALIFOR NI APPROVALS AT INSP TORSS N URE
SIGNf/ ROUGH
O F P
FINAL
IDATION JACK R ALLEN v
CK M O CASH SUPERVISING MECHANICAL ENG R
[�r-9 2 48- AFH 9 4 1 D 1 050,
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE