HomeMy Public PortalAbout9082 BROADWAY_Mechanical__ 16A364-CE8I;8 -I/70 APPLICATION FOR IT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDREIG
SS D
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN OWNER 9(
(PRINT OR TYPE ONLY)
MAIL
NO. TYPEOF APPLIANCE OR EQUIPMENTFEE ADDRESS Q ,L LOd
CITY � TEL. NO.
ABSORPTION.SYSTEM, BTU n
CONTRACTO
AIR HANDLING UNIT, CFM
ADDRESS IL e�
BOILER, HORSEPOWER CITY ' TEL. NO.3 _ %9
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. I CLASS
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE ESSED BY
EVAPORATIVE COOLER �0o
FURNACE: FAU_GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED—UNIT—
NEW —ADDITION—
USPENDED_UNIT_NEW —ADDITION_ PERMIT $ 3 00 �
Z_
ALTER—REPAIR— TOTAL FEE $ 4p
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE PECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
I
HEREBY CERTIFY SIO THAT. O E NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL 7�
CODE OF THE STATE OF CALIFORNIA.
SIGNATURE JACK R. ALLEN,.sup
R VI$ MECHANICAL ENG-R.
OF PERMITTEE
PERMIT VALIDATION CK.' M.O. CASH
PLAN CHECK VALIDATION
.00-SLito 7 ,. 8 Dr C 2 0 4 1 D 8.00-
SEE
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ,