HomeMy Public PortalAbout9588 BLACKLEY ST_Mechanical__ . 76 A,964- CE B18-1/75 '
APPLICATI FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS J O
BUIL"DING 'AND SAFETY DIVISION LOCAL Y.,� C
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) -`•"�f`�
MAIL
NO. TYPE&SIZE OF EQUIPMENT FEE AD RES s
SEE BACK OF APPLICATION -
CITY EL. NO.'
FORCE AIR FURNACE, BTU
CONTRACTOR
COMPRESSOR,•'BTU - �
ADDRESS '-` N Mo.hn h
VENTILATION FAN CIT TEL.
LIST ALL OTHERS BELOW STATE . LIC.
LICENSE NO. CLASS
(`►�/ DISTRICT N0; I GROUP ZONE SED BY
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INSPECTION RECORD
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.Plan check fee. See reverse. z
IIEWNHT ISSf'1\G F'I•:I'; S JiiD
TOTAL I''l_F: J
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO. ~
HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION -
'AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY -
,WI7HALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
EATING. AIR CONDITIONING
ROUGH
I HEREBY CER 71F T I A NOT ACTING IN VIOLATION '• //�
OF CHAPTER 9, DIVISI N 3, F �fHE USINESS AND PROFESSIONAL FINAL
CODE OF THE STATE CA. FO
15 Ki
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.0. CASH
5.7 5
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