HomeMy Public PortalAbout10218 DAINES DR_Mechanical__ w6 A 3 6 4 — CE 818 — 9-71 � �
APPLICATIO FOR P RMIT
HEATING - VENTILATING AIR CONDITIONING
COUNTY,OF LOS ANGELES ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FORpm mm APPLICANT IT FILL IN
OWNER
(PRINT OR TYPE ONLY,)
MAIL ��^--
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITYJ TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
" CITY TEL. NO.
COMPRESSOR, BTU STATE LIC
{ LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE EDBY
EVAPORATIVE COOLER �J O , C(iyy�lJ—J
FURNACE,/FAUGRAVITY INSPECTION RECORD c�
FLOOR —BTU E7
HEATER: SUSPENDED UNIT_ O
WALL
CL
N
Z
Plan check fee 257. of above. See reverse.
PERMIT ISSUING FEE S 3 00
TOTAL FEE ��
PLAN CHECK APPLICANT
NAME
LANDA
SS
TEL NO
REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
L ORDINANCES AND LAWS REGULATING HEATING, VENT1- APPROVALS E I PEC TOR'S SIGNATURE
AIR CONDITIONING '
_ ROUGH
EREBY C TIFY THAT I AM NOT ACTING IN VIOLATIONTER 9, ISION 3OF THE BUSINESSSSIONAL FINAL THE STA LIFORNIA
UREPERMIT VALIDATION CK. M O. CASH
RMITTEE
PLAN CHECK VALIDATION CK M O CASH
LAGO,7-7 2-42,�3 `24- 41' D 1 8GN CY
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE