HomeMy Public PortalAbout10940 DANBURY ST_Mechanical__ 76A364E ICE-81 Vl1l 9/" APPLICATION .FOR PERMIT
HEATING ENTILATING - AIII ' CA—Oy_—DITIONING
COU T O� ANGELES\N
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN—_ - BUILDING
(PRINT OR TYPE ONLYI ADDRESS .
'LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT. FEE - -
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER N�� -
AIR HANDLING UNIT.CFM MAIL' O
'ADDRESS
BOILER,BTU CIT LE TEL.NO,
COMPRESSOR,BTU CONTRACT R '
O
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.•NO. ,:
FURNACE: FAUGRAVITY STATE' / y/-� ,LIC.��—' 6�E�
FLOOR BTU LICENSE NO. �p�(.J CLA55 '
HEATER: SUSPENDED—UNIT— DISTRICTNO. GROUP ZONE n CE55ED BY ,
WALL
'IN ECTION RECORD
V
a
Plan che&fee 25% of above.
PERMIT ISSUING FEE$
TOTAL FEE — Z
PLAN CHECK APPLICANT
NAME '
ADDRESS
CITY TEL.NO.'
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, VENTILATING. AIR
CONDITIONING.
{ HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION OF APRROVALS DATE INSPECTOR'S SIGNAi E -
CHAPTER 9, DIVISION 3;OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OFO IA. ROUGH — x/�
SIGNATURE 'FINAL
OFPERMITTE /
PLAN CHE VALIDATION CK. N.C. cnsH PERMIT VALIDATION �- M.O. CASH
_�If�C a�' �pMPENSFATION
-- ' 7=6JUN_-21 4:,1,.D -2 7:U'U
FOUCY NUMBER.
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