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;:A3g4;cEe+e-1i70 APPLICATION FOR PERMIT
o - HEATING - VENTILATING - AIR CON.DITIQNING �.
COUNTY OF JAS ANGELES BUILDING,
DEPARTMENT OF COUNTY'ENGINEER ADDRESS
BUILDING AND SAPIF Y DIVISION LOCALITY Z
JOHN A. LAMBIE, doUN Y ENGINEKR EST /
•COLCMAN W. JBNKINS, StlP'f ftlNTXMDKNT QR OUILDING NEAREST
CROSST., L.i L.r ✓ Z
FOR APPLICANT,-TO FILL IN OWNER P . L, [�
(PRINT OR TYPE ONLY)
No. TYPE OFAPPLIANCEOR E QUIP-MENT FEE ADDRESS %t
CITY TEL NO.
ABSORPTION SYSTEM, BTU
CbNTRACTOR
AIR HANDL.lNG UNIT, CFM
ADDRESSC �LvV
BOILER, NORSEPOWEFI CIS, LO L/ TEL. NO.
�. COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. L CLASS
VENTILATION SYSTF-4 DIIITRI CT NO. CLASS GIROlur ZONE PRQCESSED EY
EVAPORAYIVE GQOLER
FURNACE: 'FAV GRAVITY jNSPtCTldfl rqtc6Rb
FLOOR—BTU
HEATER: 3USPENOED UNITT
WALL
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PERMIT S S 00 W
NfW—ADDITIQN— CL
TbTAL FEE S
ALTER_RFPAIFF:
PLAN CHECK APPLICANT
NAME f e--
ADDRESS
ADDRESS Q
CITY �i�jlJl� TEL.NO.
I Hr RELAY ACKNOWLEDGE THAT I HAYE R[AD THIS APPLICATION '
AND &TAT[ THAT THE ABOVE IS CORRECT AND AGR[[ TO COMPLY
WITH ALL 6RDIMNCKS AND'LAWS RRGULAT-1XI_N
G HEATO, VSNTI- APPROVALS DAT P[ & TUR[
LATIN@, AIR CO-IMITIOMING.'
ROUGH
IHERESY C(IRTIFY THAT I. AM NOT ACTING IN VIOLATI6N
-0F CHAPTRR 9-r DIVISION S,OF THE SUSINUS AND PROFKSSIOKA% FINAL
COAG OF THE-STAT[ OF CAL UYR IPA.
SIGNATURE JACK R. ALLIEN,SUPERVISING MEOHANICAL.ENG'R.
OF PERMITTEE !� 6f//
PERMIT VALIDATION CK: . M.O. CASH
PLAN CHECK VALIDATION
4 5 'R IN 4 4 1 9 6.GO w Z
Ra LACK OFAPPLICATIOM FDR COMPL&TG,FES SCH®ULE