HomeMy Public PortalAbout10543 FREER ST_Mechanical__ 7Q A364- CE 818- X73 ,
APPLICA N FOR P MIT
HEATING - VENTILATING - AIR CONDITION NG
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
C_ Q
NEAREST J
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) ,
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS i n
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ABSORPTION UNIT, BTU CITY TEL. NO.
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS
BOILER, BTU 95
CITYto TEL. NO.,33j-&rQ
COMPr-LESSOR, BTU STATE LIC.
LICENSE NO. 'CLASS IS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONEESSED BY
EVAPORATIVE COOLER �Jl o
FURNACE: FAUGRAVITY FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT_
/ WALL
a.
O
U
. O
F—
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Plan check fee 25% of above. See reverse. z�
PERiNlIT ISSUING FEE S •3 00
TOTAL FEE ® '
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
II HEREBY CERTIFY THAT I AM NOT CTING IN VIOLATION ROUGH
OF CHAPTER 9, DIVISION 3, OF T BUSI S AND PR ESSIONAL FINAL
CODE OF THE STATE OF CAL N �•
SIGNATURE PERMIT VALIDATION CK. M.0. CASH
OF PERMITTEE
PLAN CHECK VAL DATION CK, M.0. CASH
40; i EG
76A364-CE918 -1/70 APPLICATION FOR PERMIT -
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT
JOHN A. LAMBIE..COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNERAd
(PRINT OR TYPE ONLY) '
MAIL
No. TYPE OFAPPLIANCE-OREQUIPMENT FEE ADDRESS
ABSORPTION,SYSTEM, BTU p C e/&TEL. N a Y'S a3
CONTRACTO (/e
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, HORSEPOWER CI TEL. NO:
COMPRESSOR, HORSEPOWER STAT + LI If.
LICENSE NO eCLASS
VENTILATION SYSTEM DISTRICT NO. CLASSGROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE:. FAU_GRAVITY INSPECTION RECORD
FLOOR BTU
HEATER: ,SUSPENDED UNIT_
WALL
CL.
'
O
G7
CD
H
U
NEW_ADDITION- PERMIT. $ 3 00 d
h
Z_
ALTER-REPAIR- TOTAL FEE $
"PLAN CHECK APPLICANT'
NAME
ADDRESS
CITY TEL.NO.
I HEREBY 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, VENTI- APPROVALS DATE I CTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH •
I HEREBY CERTIFY THAT IAM NOT ACTING IN VIOLATION
OF• CHAPTER 9, DIVISION 3, 3F T E BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE F IA.
SIGNATURE JACK R. ALLEN,SUPERVISING MECHANICAL ENG'R.
OF PERMITT '
PERMIT VALIDATION . OCK. M.0. cASH
PLAN CHECK VALIDATION
13 4 1 D 8.00- '1
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE //�