HomeMy Public PortalAbout9963 DAINES DR_Mechanical__ 76A364 - CE818 - 3-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING u
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION -
JOHNA. LAMBIE, COUNTY ENGINEER LOCALITY r�
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST. f
FOR APPLICANT TO FILL IN OWNER L C�
(PRINT OR TYPE ONLY)
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NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CIT ( TEL. N
AIR HANDLLCONTRACTOR
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BOILER, HORSEPOWER c _
CITY � ,d T TEL. N0. O S�
COMPRESSOR, HORSEPOWER ^y
_LICENSE N0. J CLASS F
VENTILATION SYSTEM DISTRICT NO. GT ZONE PROCESSED BY
EVAPORATIVE COOLER
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FURNACE: FAU GRAVITY J�
FLOOR BTU -a"-'�� v'' INSPECTION RECORD
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HEATER: SUSPENDED UNIT
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NEW—ADDITION PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
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ADDRESS
CIT TEL. NO.Z�j
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI-
LATING, AIR CONDITIONING. APPROVALS DATE I PECTOR' IGNATURE
I HEREBY CERTIFY THAT I•AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF C IFORNIA
SIGNATURE JACK R. ALLEN, SUPER I MECHANICAL ENG'R. "
OF PERMITT
PERMIT VALIDATION CK. I M.O. CASH
OIL
PLAN, CK VALIDATION
Li�LO 96 5: JAN 1 4 4 1 D 8.0 0~
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE