HomeMy Public PortalAbout5223ALESSANDRO AVE_Mechanical 76A364 — CE818 — 3 69 APPLICATION FOR PERM
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FU
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) OWNER
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM BTU CITT TEL N
AIR HANDLING UNIT CFM CONTRACTOR
ADDRESS
BOILER HORSEPOWER
CITY p EL NO
COMPRESSOR HORSEPOWER STATE LIC
LICENSE NO S CLASS
VENTILATION SYSTEM DISTRICT NO GROUP ZONE P OCE,C.E,SSED BY
EVAPORATIVE COOLER
O / ('R—
FURNACE FAU GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER SUSPENDED UNIT
WALL
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V
cle
O
v
W
a
NEW_ADDITION PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $ ®0
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
IHEREBY 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
LATING AIR CONDITIONING APPROVALS DATE N PECTO SrNATURE
IHEREBY CERTIFY THAT I AM NOT A IN VIOLATION OF ROUGH
CHAPTER 9 DIVISION 3 OF THE BUSINESS A PROFESSIONAL FINAL r '�
CODE OF THE STATE OF CALIFORNIA
SIGNATURE JACK R ALLEN SUPERVISING MECHANICAL ENG R
OF PERMITTEE PERMIT VALIDATION CK J M 0 CASH
PLAN CHECK VALIDATION
1 7,,,57 4-9�2 NOV 9 4 1 D 6.00-
4 Ji �Y
41
at
i 4
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE