HomeMy Public PortalAbout5616 CLOVERLY AVE_Mechanical__ 76A364 - CE818 - 3-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS C/
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWN - / CL/
(PRINT OR TYPE ONLY)
MAIL ,
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRES-%.�
ABSORPTION SYSTEM, BTU CIT T L NO
CONTRACTOR
AIR HANDLING UNIT CFM -
ADD RES
BOILER HORSEPOWER
CITY el�TEL NO
/ COMPRESSOR, HORSEPOWER oO STATE LIC
LICENSE NO �d/ CLASS r�
VENTILATION SYSTEM DISTRICT NO GROUP ZONE
l PROC SED BY
EVAPORATIVE COOLER
I FURNACE FAP GRAVITY
FLOOR BTU S� INSPECTION RECORD
HEATER SUSPENDED UNIT
WALL
d
O
U
oe
Q
U
LL
NEW_ADDITION PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $ 7d f
PLAN CHECK APPLICANT
NAME _
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI- APPROVALS DATE INSPECTOR' SIGNATURE
LATING AIR CONDITIONING
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9 DIVISION OF THE BUSINE ND PROFESSION L FINAL
CODE OF THE STAT CALIF NIA
SIGNATURE JACK R ALLEN, UPERVISING MECHANICAL ENG'R
OF PERM ITTE
PERMIT VALIDATION CK M O CASH
PLAN CHECK VALIDATION
�l�Ci 5Ir�r SE? 1.3 4 1 D 15.50-
SEE
5.50NSEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE P
t- u