HomeMy Public PortalAbout10740 FAIRVIEW AVE_Mechanical__ 3 �'E_8I� -�9-71 ' APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES ADDRIISS vlPw
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY Cl `
NEAREST
CROSS ST < 0
FOR APPLICANT TO FILL IN OWNER Z �S —b
(PRINT OR TYPE ONLY)
MAIL �/
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS 6, Id 154 1 R U, L,J
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CITY -r, T Ci TEL NO V/7/9
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ABSORPTION UNIT, BTUe �D U /
CONTRACTOR f! �c�
AIR HANDLING UNIT, CFM /
ADDRESS -
9 , Poo'e
BOILER, BTU CITY & T-_-TEL NO
COMPRESSOR, BTU STATE / LIC
LICENSE NO 76 CLASS `L-V
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER s jAy c-
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FURNACE FAU GRAVITY
FLOOR BTU INSPECTION R D v
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HEATER SUSPENDED UNIT_ O
WALL - U
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CL
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Plan check fee 25% of above See reverse
PERMIT ISSUING FEE S s 00
TOTAL FEE I
PLAN CHECK APPLICANT L
NAME
ADDRESS c�
CITY, TEL NO a�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY y
WITH ALL ORDINANCES AND CAWS REGULATING HEATING, VENTI- APPROVALS DATE ECTOR'S SIG TURE
LATING AIR CONDITIONING
ROUGH
I HEREBY CERT THAT AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DI SIONI'9 OF THE BUSINE AND PROFESSIONAL FINAL
CODE OF THE ST E OF�ALI RNIA
SIGNATURE �,� PERMIT VALID T 1651`4 CK M O CASH
OF PERMITT E .�
PLAN CHECK VALIDATION CK M O CASH , a
u`Co " 2`C' ii—), JUL 27 4 1 1-3.00-
SEE
-3.00SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE V