HomeMy Public PortalAbout9639 BROADWAY_Mechanical__ 76 A364 - CE 818 -I/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
_ p
DEPARTMENT OF COUNTY ENGINEER AD -
BUILDING
_ AND SAFETY DIVISION LOCALITY � t
' NEAREST T /U
CROSS ST.
FOR APPLICANT TO FILL IN (OWNER
(PRINT OR TYPE ONLY) Ail 6
MAIL
" NO TYPE&SIZE OF EQUIPMENT FEF ADDRESS /✓�{ ry ./�P
SEE BACK OF APPLICATION
CITY TEL. NO.
FORCE AIR FURNACE, BTU
CONTRACTOR �� o
COMPRESSOR, BTU
ADDRESS
G
VENTILATION FAN CITY L. NQ
LIST ALL OTHERS BELOW STATE LIC.
LICENSE NO. CLASS
DISTRICT NO. UP ZONE PRO ESSED BY
�• IN PEC TION RECORD
Y
ILL
0
U
K
O
F
U
W
a
Plan check fee. See reverse.
111'A011I' ISSI`ISG FEF: $ 3 00
IOTA]HEATING,
PLAN CHECK APPLICANTNAME
ADDRESS
CITY "IHEREBY ACKNOWLEDGE THAT I HAIS APPLICATIONAND STATE THAT THE ABOVE IS CORRREE TO COMPLYWITH ALL ORDINANCES AND LAWS REHEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING. AIR CONOITIONING.
ROUGH _�NEPEBY CERiIFT THAT AM G IN VIOLPTIONOF CHAPTER 9. DIV15ION 3, OF THE BO PROFESSIONAL i. FINALCODE Oi THE STATE Oi IiORNIA.
OFP TORE S pERM1T VALIDATION cK. - M.D. cASH
SIGNAT MITTEE (
PLAN CHECK A ATION CK" M.O. CASH
1 0 7 JUV 30. 44 1) 1 05 0 Ar;E