HomeMy Public PortalAbout10611 DAINES DR_Mechanical__ 96A_366C ,
CE 616 REV.6/781
u. APPLICATION 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 C L
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE L
NEAREST
CROSS ST.
ABSORPTION UNIT.BTU
OWNER - / y
AIR HANDLING UNIT,CFM 'MAIL '
ADDRESS
BOILER,BTU CITY TEL.NO.
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS le7
EVAPORATIVE COOLER
CITY _ � >eTEL.NO.Lf4.,6
FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU Q LICENSE NO. O r CLA55
HEATER: SUSPENDED—UNIT—
APPROVALS Dare INSPECTORS SIGNATUREW ALL
ROUGH t
FINAL 9 r--21
O
INSPECTION RECORD V
cc
0
Plan check fee 25% of above.
PERMIT ISSUING FEE; 7 — Z
TOTAL FEE / 7 —
PLANCHECKAPPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL.NO. .
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND O 8 5 A
STATE THAT THE.ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING. VENTILATING. AIR AA
CONDITIONING. , 0 0 0 O y
PERMIT VALIDATION '
CHAPTSER9E HEREBY CERTIFY
3, OF THE BUSINESS AND G IN PROFESSIONAL ROFESSIIONALOCODE O O ' 7 Q O
OF THE STATE OF CALI ORNIA.
SIGNATURE 'O'O O 1 7.005
OF PERM ITT EE •p p
DISTRICT NO. PROCESSED BY I' l'A I' 7-7 Ca
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