HomeMy Public PortalAbout5039 FRATUS DR_Mechanical__ 76 A364j CE 818-1/75
r APPLICATION FOR PERMIT
- HEATING - VENTILATING - AIR CON01110NING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY'
NEAREST
CROSS ST ,' A
FOR APPLICANT TO FILL IN OWNER rs�
(PRINT OR TYPE ONLY)
NO MAIL
'TYPE&SIZE OF EQUIPMENT FEE ADDRESS 5-03,7 �2�T(!�
SEE BACK OF APPLICATION CITY ` TEL NO
_ FORCE AIR FURNACE, BTU �y
CONTRACTOR //2S�ECi L Tl
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VENTILATION FANCITY IT TEL NO
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LIST ALL OTHERS BELOW STATE LIC
LICENSE NO _70215vo CLASS C LQ
iDISTRICT NO GROUP ZONE 411I SED BY
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PLAN CHECK APPLICANT
NAME
ADDRESS r
CITY TEL NO
I HEREBY ACK40WLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECTI AND AGREE TO COMPLY -
WITH ALLORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING AIR CONDITIONING
I HEREBY CERTIFY THAT I AM NOT ACTIN IN VIOLA710 ROJGH _
OF CHAPTER 9 DIVISION 3, OF THE BUSIN S A PROFES N + FINAL ✓,
CODE OF THE STATE 0 IFORNIA
SIGNATURE
OF PERMITTPERMIT AL - ION (c I, M 0 CASH
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PLAN CHECK VALIDATION CK M o CASH
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76A364E IGE 816A) 9/77 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR DITIO MING
OUNTY O OS ANGELES
' DEPARTMENT COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING �.70
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(PRINT OR TYPE ONLY_) ADDRESS ./0r
LOCALITY t
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST ENT �►ID
ABSORPTION UNIT BTU /�,�
OWNER 'Per6 � W/t use"'pm-
MAIL
AIR HANDLING UNIT CFM ADDRESSTvS'
BOILER BTU
CITY G� STEL NO 6� 0
COMPRESSOR BTU c 000 `
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CONTRACTOR E r A.�LL&s
VENTILATION SYSTEM ADDRESS S7 . l_
EVAPORATIVE COOLER CITY % V8` TEL NO fg
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FURNACE FAU GRAVITY STATELIC
FLOOR BTU LICENSE NO 30Z%5-00 CLASS G�y
HEATER SUSPENDED UNIT- DISTRICT NO GROUP ZONEPRO SSED BY
WALL ^
INSPECTION RECORD d
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Plan check fee 25% of above u
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PERMIT ISSUING FEE$ R vii
` TOTAL FEE Z
1 PLAN CHECK APPLICANT
rr NAME
Y
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 HEREBY CERTIFY THAT I AM NOT ACTING IN VI LATION SOF APPROVALS DATE INSPECTOR 5 SIGNATURE
CHAPTER 9 DIVISION 3 OF THE B SINES AND P E_ NAL CODE ROUGH
OF THE STATE�RNIA
SIGNATURE
OF PERM ITTE <�
PLAN CHECK VALIDATION CK Mo CASH PERMIT VALIDATION Mo CASH
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