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76A3e4k=4'Ee,e - -s9 APPLICATION FOR ,PERMIT
t•. HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING G
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION -Op
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY I
COLEMAN W. JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSSST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL. NO.
CONTRACTOR
AIR HANDLING UNIT, CFM
BOILER, HORSEPOWER ADDRESS 'Z7/
TY TEL.
COMPRESSOR, HORSEPOW ERI� i STAT
TNSE /P/;(�3 LIC. /P � '7O
LICEE NO. S•O b' J CLASS
VENTILATION SYSTEM DISTRICT N0. GROUP 'ZONE PR C EB r
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY
FLOOR BTU X00 115 INSPECTION RECORD
HEATER: SUSPENDED_UNIT_ }
WALL a
O
V
O
1-
u V
w
a
' N
_Z
NEW_ADDITION_ PERMIT $ 3 00
ALTER--REPAIR_ TOTAL FEE S
PLAN CHECK APPLICANT
NAME
CITY - TEL. //
IHEREBY 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 ECTOR'S NATURE
LATINS, AIR CONDITIONING.
IHEREBY CERTIFY
THA AM NOT ACTING IN VIOLATION OF ROUGH 1711
CNA PTER " DIVISION 3 THE BUSII S ANO PROF 5510NAL FINAL
CODE OF THE STATE OF IFORNIA.
SIGNATURE JACK R. ALLEN, SUPERVI HANICAL ENG'R.
OF PERMITTEE
' PERMIT VALIDATION CK. .o. cnsH
PLAN CHECK VALIDATION
uio
Nov 16 41 0 13.00—
.SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE