HomeMy Public PortalAbout5439 CLOVERLY AVE_Mechanical__ 76A364C
CE 818 (REV 11/78)
&, APPLICAT N FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE I
NEAREST
CROSS ST
ABSORPTION UNIT BTU ,
,OWNER e5 /
AIR HANDLING UNIT CFM MAIL t— ® l (�
, ADDRESS
BOILER BTU CITY T��.y�r/� `� TEL NO�f77,-
O O
COMPRESSOR BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITYKI/V jV TEL NO
FURNACE FAU GRAVITY STATE LIC
FLOOR BTU LICENSE NO CLASS
HEATER SUSPENDE UNIT_ APPROVALS DATE INSPECTOR S SIGNATURE
WALL '—
ROUGH
/ IL
FINAL O
�.� V
INS1:�ThORECORD � pQ
Plan check fee 25% of above
PERMIT ISSUING FEE$ Z
TOTAL FEE ---
PLAN CHECK APPLI NT PLAN CHECK VALIDATION
NAME
ADDRESS
�847.5A
CITY TEL NO # o - 41
7.00
I HEREBY A y NOWLEDGE THAT I HAVE READ THIS APPLICATION AND 2,- 1 /,0 0
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR — 17,005)
CONDITIONING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM N ACTING IN VIOLATION OF 0 IT 0'4—8 0
CHAPTER 9 DIVISION 3 OF THE BU AND PR SSION OD
OF THE STATE OF CA IA
SIGNATURE L '
OF PERMITTEE '
DISTRICT NO CE
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