HomeMy Public PortalAbout9814 BROADWAY_Mechanical__ ""'B°E- `VBI. 31/75 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
P®
I 1�, SAFETY DIVISI
FOR AP.PL.ICANT TO FILL IN BUILDING '/ -
(PRINT OR TYPE ONLY) C ADDRESS O-
LOCALITY
NO. TYPEp FAP PLIA NCE OR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM. MAIL
ADDRESS
BOILER, BTU CITY TEL. NO.
.COMPRESSOR, BTU CONTRALTO
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY >Y TEL. NO_ 7f 9 OD
FURNACE: FAUGRAVITY STATE LIC. _
FLOOR BTU LICENSE NO. I,k7(1CLASS.
HEATER: SUSPENDED—UNIT_ DISTRICT NO. GROUP ZONE PROCESSED BY y
WALL•'
INSPECTION RECORD
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N
Z
Plan check fee 25%G of above.
PERMIT ISSUING FEE S
TOTAL FEE r
PLAN CHECK APPLICANT - -
NAME -
ADDRESS -
CITY TEL.NO.
I N
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO -
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND
LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING,
HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL ROUGH _
CODE OF THE STATE OF Cp IFORNIA. '
SIGNATURE
OF PERMITTEE_ _ FINAL
PLAN CHECK-VALIDATION CK. M.D. CASH MIT VALIDATION M,O. cases
- 98 * APR' 28'.4:1- 0 9..0 Aga
76 A36A - CE BIB-1/]B
APPLICION FORCP E
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION "LOCALITY
NEAREST
CROSS ST. .Q L'puJ/A/
.FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION -
�j CITY TEL. NO.
FORCE AIR FURNACE, BTU TE
CONTRACTOR �_ _COMPRESSOR, BTU 3G/ �'`�2 �� �� '-
ADDRESS �ZZ �'V>iE6�Gti �ji�S
VENTILATION FAN. CITY
LIST ALL OTHERS BELOW STATE LIC.
11 LICENSE NO. Z2''Z CLASS —�'�
DISTRICT NO. GROUP 20NE ESSED BY
G� �i -15
INSPECTION RECOR
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ra o e v i a ! tP v ! p i .rCf. �'7- 979
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U
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Plan check fee. See reverse.
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PI>R>IFP ISSGUG FEV S 3 00
'1 AL I'1;1•: vt�
PLAN CHECK APPLICANT
NAME
ADDRESS -
CITY TEL.NO. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WIT ALL ORDINANCESAND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING. AIR CONDITIONING.
ROUGH
HEREBY CERTIFY THAT 14 OT ACTING IN VIOLATION
OF CXAPTER 9, OI VISION 3, 0 SINESS ANOPROIESSION4L FINAL L
CODE OF THE STATE OP C O NIA. -2 7zgC4
SIGNATURE G +��� PERMIT VALIDATION cK. .0. CASH
OF PERMITTEE
PLAN CHECK V DATION cK, M.G. CASH 2
0.01$rJUf9 25 41 D 3.0 0 e93