HomeMy Public PortalAbout10249 FREER ST_Mechanical__ 76A364e (CE-6,9A)-11/76 APPLICATION FOR PERMIT '
HEATING - VENTILAT.ING - AIR CONDITIONING
UNTY OF LOS GELES
DE MENT OF C TY ENGINEER
BUILDING'AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)' /
LOCALIT
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL `
ADDRESS
BOILER,BTU CI NO
COMPRESSOR,BTU CONTRALTO
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL NO
FURNACE FAU_GRAVITY STATE LIC. i
-FLOOR BTU LICENSE NO. CLAS�(�
HEATER SUSPENDED UNIT- DISTRICT NO. G UP ZONE PROCESSED BY
WALL
INSPECTION RECORD d'
•U u
u
O
Plan check fee 25% of above. u
PERMIT ISSUING FEE$ Z
TOTAL FEE —
PLAN CHECK APPLICANT
NAME - - - -
ADDRESS -
CITY TEL NO.
IHEREBY ACKNOWLEDGE THAT-1 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 HETHAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, "Ply OF BUSINESS AND PROFESSIONAL CODEROUGHOF THE STATA 'SIGNATUREFINAL `OF PERM ITT �•
PLAN CHECK VALIDATIO cK Mo CASH PERMIT VALIDATION K MO CASH
COMPENSATION
O d 5C-SEP 23 4 1 D21.0 0 aJYJ
POLICY. HOLDER:G��,p � -
POLICY NUMBER: �`'� Os