HomeMy Public PortalAbout9082 EMPEROR AVE_Mechanical__ '76A364E ICE 618A) •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 �n
(PRINT OR TYPE ONLY) ADDRESS L/
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST L
CROSS ST
ABSORPTION UNIT BTU �.
OWNER T
AIR HANDLING UNIT CFM MAIL
/ ADDRESS /
BOILER BTU X16__00 J CITY TEL NO
COMPRESSOR BTU
CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL NO
FURNACE FAU_GRAVITY STATE //� LIC 3
FLOOR BTU LICENSE NO `� CLASS
HEATER SUSPENDED UNIT- DISTRICT NO GROUP ZONE ROLES BY
WALL
INSPECTION RECORD d
O.
v
Plan check fee 25% of above
PERMIT ISSUING FEE$ Z
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
IHEREBY 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 '
I HEREBYCERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR S SIGNATURE
CHAPTER 9 DIVISION 3 OF THE BUSINE AND PROFESSIONAL ODE
OF THE STATE OF C LIF RNIA ROUGH
SIGNATURE FINAL
OFPERMITTEE
PLAN CHECK VALID ION CK Mo CASH PERMIT VALIDATIO cK Mo CASH
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1. 9 6 0 AUG 15 4 1 D 1- 5.7 5 ,&�lu