HomeMy Public PortalAbout5204 DOREEN AVE_Mechanical__ 76Aa64 -,c€eIe - 3-1� - APPLICATION FOR PERMIT
HEATING - VENTILATING -AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS -f>' / /4 ese Efs•�!' L
BUILDING AND SAFETY-DIVISION �' /^
JOHN A. LAMB„E, COUNTY ENGINEER LOCALITY•L C�� CC C..:`.
COLEMAN W. JENKINS,SUPERINTENDENT OF BUILDING. NEAREST n
CROSS ST. F�e.Ec�2
FOR APPLICANT'TO FILL IN OWNER
(PRINT OR TYPE ONLY) / -
MAIL
NO. .TYPE OF APPLIANCE OR EQUIPMENT FEE ADER ESS J r[}C{- /✓ O
"ABSORPTION SYSTEM,SYSTEM, BTU CITY.. -u ��.cd TEL. N0. 7/ v
CONTRACTOR. J� ta'�� '
AIR HANDLING UNIT, {FM - - -
ADDRESS -
BOILER, HORSEPOWER -
CITY TEL. NO.
COMPRESSOR; HORSEPOWER ® STATE,,. LIC.
_ LICENSE NO. CLASS
'VENTILATION SYSTEM I DISTRICT NO. GROUP ZONE PRO ESSE 'B
EVAPORATIVE COOLER - l.�/^U •' ��
FURNACE; FAU -.GRAVITY .
FLOOR - BTU INSP CTION REC RD
HEATER: SUSPENDED_UNIT_ -'WALL C_
.. 0
2c49 eta o
z
NEW_ADDITION_ PERMIT' $ 3 00 �.
ALTER_REPAIR_ TOTAL FEE S.
PLAN CHECK APPLICANT - •
NAME
ADDRESS
CITY TEL.. 140.
IHEREBY ACKNOWLEDGE THAT I HAVEREAD THIS APPLICATION`, '
ANO STATE-THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY.
WITH ALL ORDINANCES AND LAWS-REGULATING HEAT,,NG,VENTI=l APPROVALS DATE IN CTOR'S SIGNATURE.
LATING, AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM'NOT JkCTING IN VIOLATION OF: ROUGH -
CHAPTER 9, DIVISION 3, OF THE BUS ESS AND PROFESSIONAL 'FINAL' -
CODE OF THE STA_LE OF CALIFORNIA.
1
SIGNATURE j JACK R. ALLEN, SUPERVISING MEC XANICAI-ENG'
OF PERMIT TrE
PERMIT VALIDATION I CK. M.G. cnsH -
PLAN CHECK VALID TION - '
� Ar-6,57;8 SEP 141 D . 7.00” 4
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
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