HomeMy Public PortalAbout9910 DUFFY ST_Mechanical__ 76A364E ICE-616A1- 11/76 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
. BUILDING AND SAFETY DIVISION '
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT.CFM MAIL I h
ADDRESS lJ
BOILER,BTU CITY TEL.
� - N
COMPRESSOR.BTU _ CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO
FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU 'LICENSE NO. CLASS
HEATER: SUSPENDED UNIT— DISTRICT NO. GROUP nZONE PROVED BY
WALL—
(505
ALL (5 O Q0.
/ Cl �
INSPECTION RECORD 0
O
u
O
1-
Plan
Plan check fee 25% of above.
PERMIT ISSUING FEE$ w
TOTAL FEE 9 ri-0Z
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION AND
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING. AIR
CONDITIONING.
HEREBY CERTIFY THAT I AMNOTACTING IN VIOLATION'OF APPROYAlS DATE (NSP iOR'S SIGNATURE
CHAPTER DIV( ON 3. OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STAT9,E C LIFORNIAROUGH,, 7-7-1-72
SIGNATURE FINAL
OFPERMI
PLAN CHECK VALIDATION CK. M.D. CASH, PERMIT V L ATION cK. D.o, cnsN
7 4 7NJUL 22 41D 9.0
o.