HomeMy Public PortalAbout5556 BALDWIN AVE_Mechanical__'6A364-CE 818_8_68 APPLICATION FOR.PERMIT
- HEATING - VENTILATING - AIR CONDITIONINly
• . ' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ��� %�
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING INEAREST
LOCALITY 7i C
FOR APPLICANT TO FILL IN CROSS ST. 0 C V
(Print or type only)
OWNER Of
No. TYPEJOFAPPLIANCE OR EQUIPMENT FEE
MAI L
ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL. NO. f
AIR HANDLING UNIT, CFM CONTRACTOR L r^
BOILER, HORSEPOWER ADDRESS
COMPRESSOR, HORSEPOWER CITY TEL. NO.
STATE LIC.
VENTILATION SYSTEM LICENSE NO. CLASS
DISTRICT NO. GROUP ZONE �,,]FSS BY
EVAPORATIVE COOLER yy'�
FURNACE: FAU GRAVITY V i
FLOOR-BTU INSPECTION RECORD
HEATER:.SUSPENDED UNIT
WALL
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NEW_ADDITIOA PERMIT S 3 00
ALTERREPAIR TOTAL FEE S ov
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Plan check applicant
Name
Address
City Tel. No.
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, VENTI- APPROVALS D E IN CTOR'S URE
LATING, AIR CONDITIONING. /,.
ROUG H
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION FINAL
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE,yO�F CALIFORNIA. [ JACK R. ALLEN,SUPERVISING MECHANICAL
9'L
8 PERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE �w
PLAN CHECK VALIDATION
3 6 7 8 FEB 13 1 D 6.0 0-
SE E
-SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ..fin