HomeMy Public PortalAbout10936 DAINES DR_Mechanical__ 76 A36'4�- CE BIB-t/]6
T APPLICATION FOR PERMIT
HEATING - VENTILATING • AIR CON017-IONING
COUNTY OF LOS ANGELES BUIL
ADpRD'SS
DEPARTMENT OF COUNTY ENGINEER'
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. i5 /f4— - ll
FOR APPLICANT TO FILL IN OWNERG/ Y��r� _
(PRINT OR TYPE ONLY)
N0. TYPE&SIZE OF EQUIPMENT FEE MAIL A _
ADDRES
SEE BACK OF APPLICATION - _
CIT VTEL. NO� [.
FORCE AIR FURNACE; BTU �P7y� ' 'v - � ' " 'C
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�y CONTRACTOR U �_��� ,J� ✓
/ /COMPRESSOR, BTU J(�IyJ ' ,
ADORESs
VENTILATION FAN CITY / A TEL. NO,Ago
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LIST ALL OTHERS BELOW STAT
LICENSE NO LIC,
CLASS
DISTRICT NO. GROUP ZONE _ OCE 55BT
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INSPECTION RECORD
6
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Plan check fee. See reverse. _
' PGHVIIT IS51.-IAC FG.I'. S o -
TOTAL FEF y91 -
PLAN CHECK APPLICANT ,.
NAME
ADDRESS -
CITY - TEL NO.' S
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION -
ANO 5TATg.THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL THAT
AND LAWS REGULATING HEATING, VENTI- -APPROVALS DATE INSPECTOR'S SIGNATURE.
LATING;AIR CONOITI ON I NG,
ROUGH
I HEREBY CERTIFY 4NAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, 0ON OF THE BUSINESS AN PR ESSIONAL FINAL.
CODE OF THE 5- TE OF LI ORNIA
SIGNATURE _ _ Q_ PERMIT-VA I ATION - cK. M.O. CASH _
CD PERMIT E _
PLAN CHECK VALIDATION CK. M.D. CASH / -
93 7 v 84 D 1 9.506`