HomeMy Public PortalAbout4515 CLOVERLY AVE_Mechanical__ 76A364 - CE818 - 5-69 - -�-��� C
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANCELIES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY 114 1p V TEL. N0. — �11
AIR HANDLING UNIT, CFM CON RACTO
,
BOILER, HORSEPOWER ADDRESS
CITY TEL. NO.
COMPRESSOR, HORSEPOWER Z Y 6 STATE LIC.
4� LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE CESBED BY
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY
FLOOR BTU INSPECTION RECORD
EATER: -SUSF5ENDED UNIT
WALL
O
V
o[
O
NEW—ADDITION— PERMIT S 3 00
Z
ALTER�tEPAIR_ TOTAL FEE $ S
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TLF
I HEREBY ACKNOWLEDGE THAT I HAVEPLICATION
AND STATE THAT THE ABOVE IS CORRECTO COMPLY
WITH ALL ORDINANCES AND LAWS REGING,VENTI- [FI
APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.I HEREBY CERTIFY THAT I AM NOT LATION OF GHCHAPTER 9, DIVISION 3, OF THE SIF SSIONAL LCODE OF THE STAT CALIFORNISIGNATu JACK R. ALLEN, SUPERVISI G MECHANICAL ENG'R.
OF PERMI RMIT VALIDATION CK. M.0. CASH
PLAN CHECK VA&ErATION
LIfA,l$ 41 69 Ae 4 4 1 D 8.0 0, 9 ,
:E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE