HomeMy Public PortalAbout10930 DAINES DR_Mechanical__ 76a36-4 s'�EB!8 V 3-69 `
APPLICATION FOR PERMIT q
HEATING - VENTILATING - AIR CONDITIONING l
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 14pyllo
BUILDING AND SAFETY DIVISION �.
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W. JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) OWNER
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT - FEE AODRESS t e�
ABSORPTION SYSTEM, BTU ee -M vv CITY (_-. TEL. NO.
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS 6
BOILER, HORSEPOWER
CITY � q.A..(�l+ TEL. N0.
COMPRESSOR, HORSEPOWER q
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LICENSE N0. ley 6 CLA55 C'e1D' V 3
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE ROCESSEO BY
EVAPORATIVE COOLER D [L { 6
FURNACE: FAU GRAVITY_ /7
' FLOOR - BTU jorm INSPEC N CORD
HEATER: SUSPENDED-UNIT-
WALL
USPENDED_UNIT_ tG ��
WALL }
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10,
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NEW_ADDITION_ PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI-
LATING, AIR CONDITIONING. APPROVALS GATE INSPECTOR'S SIGNATURE
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND .PROFESSIONAL FINAL
CODE OF THE STATE 0 CALIFO/q/NIA. ///fff
SIGNATURE /+� •�(- 7.1 ���fjj... 7 JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE ( 'LC N'C`6� !/(t-
PERMIT VALIDATION crc. M.o. cpsH
PLAN CHECKVALIDATION -
�u�� '5: ,g 3 4 1 0 1 2.00 ^<
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE