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APPLICATION FO FERMI (//�`®
IDEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES 7NEAREST
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT QF BUILDINGFOR APPLICANT TO FILL IN(PRINT OR TYPE ONLY)NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE
CITY TEL. NO.
ABSORPTION SYSTEM, BTU
CONTRALTO 1/1 �
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AIR HANDLING UNIT, CFM
ADDRESS v
BOILER, HORSEPOWER
CIT � � TEL. NO._��—,Z
COMPRESSOR, HORSEPOWER ) STATE / LIC.
LICENSE NO. � CLASS
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE OC ED BY
EVAPORATIVE COOLER _-7— - /
JFURNACE: FAU GRAVITY r_ INSPECTION RECORD
FLOOR BTU
HEATER: .SUSPENDED-UNIT-
WALL
USPENDED UNIT_WALL
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CD
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CD
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NEW—ADDITION— PERMIT $ 3 00 N
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ALTER—REPAIR— TOTAL FEE $ /goo
PLAN CHECK APPLICANT (�
NAME
ADDRESS
Cl TY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOWITH ALL ORDINANCES AND LAWS REGULATING HEATINGAPPROVALS .DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
IHEREBY CERTIFY T�AMAC G IN VOF CHAPTER 9, DIVISIO D P FEFINAL Al �s'��
CODE OF THE STATE 0 C
SIGNATURE JACK R. ALLEN,SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION M.0. CASH
PLAN CHECK VALIDATION
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE