HomeMy Public PortalAbout5740 CLOVERLY AVE_Mechanical__ 76A364C 7
CE 818 (REV 11/78)
05 APPLICATION FOR PERMIT , r
HEATING - VENTILATING - AIR,CONDITIONING `
COUNTY OF LOS ANGELES BUILDING AND SAFETY i
FOR APPLICANT TO FILL IN, BUILDING
ADDRESS (/ ,
(PRINT OR TYPE ONLY) I „
_ LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
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ABSORPTION UNIT BTU,
OWNE-R �
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AIR HANDLING UNIT CFM MAIL w
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BOILER BTU CITY TEL NOeoot-
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COMPRESSOR BTU ®� " '� CONTRACTOR
VENTILATION SYSTEM ADDRESS 1yg 4,t/
EVAPORATIVE COOLER ^
CITY' TEL N0-4
FURNACE FAU ` GRAVITY,— STATE LIC
' FLOOR t BTULICENSE NO CLASS G"
1 HEATER SUSPENDED UNIT-__ LL �t'' i , APPROVALS DATE INSPECTORS SIGNATURE C ,
K WALL
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FINAL -7+L- d�,,. O
INSPECTION RECORD py
Plan check fee 25% of above N
" PERMIT ISSUING FEE$ gooZ
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TOTAL FEE y0 .
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PLAN CHECK APPLICANT ,,a 1 PLAN CHECK VALIDATION -�
NAME
ADDRESS
CITY TEL Nd g- Q 8J
I HEREBY-ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND ,x Z"9 ,a,3 A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL +' 1
ORDINANCES `AND LAWS REGULATING HEATING VENTILATING AIR # O oFo o [I
CONDITI ONINGr ` '01' PERMIT VALIDATION '° ^
I HEREBY CERTIFY THAT AM OT ACTING IN VI N OF r 2 O o 1 N7,O 0
CHAPTER 9 DIVISION 3
OF
BU NESS AND PR=E
L C DE <
OF THE ST9 DIVISION
CALIFORNI t„ 7 , `e o 7,Q 0,2:
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SIGNATURE ,.//�� '1, I
OF PE RMITTEE 0 4, 1 ,1 —, 80
DISTRICT NO`/ 1 PROCESSED BY
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176 A364- CE 818- 5--73 '
APPLICATION FOR P '��I
HEATING - VENTILATIN,G - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS N V
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALI _fn C
ilu
NEAR EST
CROSS ST &JPIIS
FOR APPLICANT TO FILL IN OWNER
+' (PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS p��
CITY TEL NO
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS' ue-
0
BOILER, BTU CITTEL NO
COMPRESSOR, BTU STATE if - LIC
LICENSE NO a `CLASS C ^-
VENTILATION SYSTEM DISTRICT No GROUP ZONE 5ESS BY
EVAPORATIVE COOLER
/ FLOORFURNACE FAU BTU( GRAVITY INSPECTION REC \
RD
HEATER SUSPENDED ' UNIT_
WALL
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W
CL
Plan check fee 25% of above See reverse z
PERMIT ISSUING FEF,$ h
TOTAL FEE 1 17
PLAN CHECK APPLICANT
NAME -
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT IHAVE 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'S SIGNATURE
LATING, AIR CONDITIONING ° d
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DIVI��IFO"IA
OF THE BUSINE S AND PROFESSIONAL FINAL
CODE OF THE STATE '
SIGNATURE ii� O • N
OF PERMITTEE a • P� _ 17'_—�/ _ I CK M CASH
PLAN CHECK VALIDATION CK NVl 0— —tASP 4-' N CD • F
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