HomeMy Public PortalAbout4937 ENCINITA AVE_Mechanical__ 76 A364'- CE 818-'1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CON0I110NING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAI L
NO TYPE&SIZE OF EQUIPMENT FEE A D D R SS ..
SEE BACK OF APPLICATION /
CI TEL NO�
FORCE AIR FURNACE, BTU
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COMPRESSOR, BTU
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VENTILATION FAN CITEL NO<:?,,X;Z- 6TV
LIST ALL OTHERS BELOW STATE r LIC
LICENSE NO ✓ CLASS
-17
DISTRICT NO GROUP ZONE PR ESSED Y
INSPECTION'RECOR
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Plan check fee See reverse z
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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 VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LAT ING AIR CONDITIONING i
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DI ISION 3 OFZINESS AND PROFESSIONAL FINALCODE OF THE T OF LIFO
SIGNATU PERMIT VALIDATION CK M oo�''/"/�i/ CASH
OF P E
PLAN CHECK VALIDATION cK M o CASH
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