HomeMy Public PortalAbout6005 ENCINITA AVE_Mechanical__ 7BA364E ICE'818N 8"7 APPLICATION FOR PERMIT
HEATING -MNTILATING AI/Q,COfdDITIONING
COUNTYWFLOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY( ADDRESS , (J
LOCALITY /r � �p��
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE �-Y
NEAREST E
GROSS ST. J I
ABSORPTION UNIT,BTU Y
OWNER
AIR HANDLING HANDLING UNIT.CFM MAIL
ADDRESS
BOILER.BTU CII L.NO.
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM .ADDRESS
EVAPORATIVE COOLER CITY
FURNACE: FAU-GRAVITY STA E LIC
LICENSE NO. CLASS
FLOOR BTU
HEATER: SUSPENDED-UNIT- DISTRICTNO, GROUP ZONE PROCESSED By
WALL
q 77 G INSPECTION RECORD, u
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Plan check fee 25% of above. . w
PERMIT ISSUING FEE$ 01
Z
TOTAL FEE /*.
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWSPA.
HEATING. .VENTILATING. AIR
CONDITIONING.
I HEREBY CERTIFYIOT AC NG IN VIOLATION OF APPROVA; DATE INS P ECTOR'S SIGNATURE
CHAPTER 9. DIVISION 3. 55 AN PROFESSIONAL CODE �
ROUGH 77
OF THE STATE OF CAUFOR -�L
SIGNATURE FINAL
IT
OF PERMTE
PLAN CHECK VALIDATION w CASK PERMIT VALIDATION - M.o. cpsH
7 8 6frEB 22 4-1 D 15.75 Ayt$
76A364 - C EBIB - 3-68
APPLICATION FOR PERM(
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS600S 61v.;
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY /
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER uU d
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEEADDRESS
ABSORPTION SYSTEM, BTU CITY TEL.
1
AIR HANDLING UNIT, CFM CONTRACTOR
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ADDRESS COOS A/
BOILER, HORSEPOWER
CITY TEL. NO t}'•�i U/
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DI/STRICT NO. GROUT, ZONE ROC SSEO Y
EVAPORATIVE COOLER
FURNACE: FAU -GRAVITY—
FLOOR
RAVITYFLOOR BTU INSPECTION RECORD
HEATER: SUSPEN ED UNIT_
WALL
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NEW—ADDITION-1 PERMIT y 3 00 Z
ALTER--REPAIR— TOTAL FEE $ 00 .
CHECK APPLICANT //7"x
NAME G (!Q�✓a.
ADDRESS
CITY -� C- TEL NO
I HEREBY A KNOWLEDGE THA I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI- APPROVALS A E 1 PECTOR SIGNATURE
LATING, AIR CONDITIONING.
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH O
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF CALIFOR
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL E
OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
ip 517OE2 Mil 1 41 D 7.00
2 ! c�FEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE