HomeMy Public PortalAbout9966 DUFFY ST_Mechanical_03/18/1976 76 A364.- CE 818 -1/75 -�
A LICATION F RMIT
HEATING - ENTILATIM• - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS [�
DEPARTMENT OF COUNTY`-ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
•V
NEAREST v
_ CROSS ST.
FOR APPLICANT-TO FILL IN
OWNER
(PRINT OR TYPE ONLY)
MAIL-
NO TYPE&SIZE OF EQUIPMENT FSE' ADDRESS
SEE BACK OF APPLICATION -
CITY TEL. NO:`
FORCE AIR FURNACE, BTU
„S -
COMPRESSOR, BTU CONTRACTOR A' RX� Cer C L`
ADORE *<-A MA2Y
VENTILATION FAN C.I.Tg� ® TEL. NO,� j 2�
LIST ALL OTHERS BELOW STATE A , ` G C://�� LIC. /� h
LICENSE NQA !� ov CLASS.. -L0
00 ❑157R1CT NO. GROUP- Z/O\/N E- SSE D BY
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INSPECTION RECORD
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Plan check fee: See reverse.
P6;li\IIT I,S.MJEN ;: FK,L:
TOTA1,
-PLAN CHECK.kPPLICANT
NAME
A DDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
A.ND'STATE THAT -THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS 'REGULATING,HEATING, VENT1- APPROVALS DATE. INSPECTOR'S SIGNATURE
LATING. AIR CONDITIONING.
• ROUGH - z7-�
I HEREBY CERTIFY THAT I AM NOT ACTING I VIOLATION
OF CHAPTER 9, DIVISION 3, F THE BUSINES ND P /FEESSIONAL FINAL .-�Z77 .�.
CODE OF THE STATE FOR . C �.�../
SIGNATURE PERMIT VALIDATION -CC �. M.O. CASH
OF PERMITTEE a PLAN CHECK"VAL ATION CK. M.O. CASH
779 84 11 v:50 �i