HomeMy Public PortalAbout5115 CAMELLIA AVE_Mechanical__ 7EA3M49(Qin-IS IBAI-9/77
APPLICATIOW FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUI I
ADDRESS
(PRINT OR TYPE ONLY)
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
_
CROSS ST.
ABSORPTION UNIT,BTU nh�t
OWNER
AIR HANDLING UNIT,CFM MAIL /�
ADDRESS `
BOILER,BTU C TEL NO,2 r .?,6
COMPRESSOR,BTU CONTRA OR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL NO.
FURNACE: FAUN G V STATE LIC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED UNIT- DISTRICT No. GROUP ZONFPROCESSED BY
WAI I
INSPECTION RECORD
Plan check fee 25% of above.
PERMIT ISSUING FEE$
TOTAL FEE --
PLAN CHECK APPLICANT '
NAME !J
ADDRESS l S
CITY TEL NO.
1 HEREBY VCKNOWLEDGERHAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPALS DATE INSPECTORS SIGNATURE
CHAPTER 9, DIVLSION !, OF TMBAND PROFESSIONAL CODE
OF THE STATE OF ALF RNLI. ROUGH .�
SIGNATURE FINAL
OF PZRAI",
PLN CHECK VALIDATION CK. wo. CASH PERMIT VALIDATION Cmoo. CASH
A
767"R 6 b o 2 57.0 0