HomeMy Public PortalAbout10847 FREER ST_Mechanical__ 7e"364E " °Ee1813"9i75 APPLICATION FOR,PERMIT
HEATING - VENTILATING -.AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
Le
AIR'HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE C O R CITY ` TEL. NO. 123
FURNAFLOORCE: FAU BTU R Y STATE'� LICENSE N -3 LICENSE 2_ CLASS !,O
HEATER: SUSPENDE UNIT_ DISTRICT NO.' GROUP ZONE PROC SED-BY
WALL 01,
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INSPECTION RECOVD
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE a1
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- -
LATING, AIR CONDITIONING. t
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISION 3 THE BU ES AND PRO FE ZONAL pq q�q ''� /
CODE OF THE STATE NIA ROUGH - !/6/•/l(r3_�'C�i J �
SIGNATURE -?
OF PERMITTEE FINAL
PLAN CHECK VALIDATION PERM VALIDATION (��Vi CASH
CK, M,O. CASH
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78A364E ICBG-618A1- 11/76 `—_— APPLICATION FOR fEfl IMIT
� . HEATING -.VENTILATING - Al CORDITIONING -
COU
OF LOS ANGELE
DEPARTMENT OF COUNTY E NEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN' AooRess
(PRINT OR TYPE ONLY) -
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY LE Q. IT
NEAREST �/�
CROSS ST .c,30,.j•y..A j'N I T6q
ABSORPTION UNIT,BTU r�
OWNER, rs-
-AIR HANDLING UNIT,CFM MAIL, 'D
ADDRESS 16 8 41
l F PtC.
BOILER,BTUq
CITY �GIA'l L� /1 IT TEL NO�!,j
COMPRESSOR,BTU
• CONTRACTOR
VENTILATION SYSTEM ADDRESS L
EVAPORATIVE COOLER CITY TEL NO '
FURNACE FAU GRAVITY - STATE LIC
FLOOR BTU LICENSE NO CLASS
HEATER: ,SUSPENDED UNIT- DISTRICT NO GROUP ZONE 2ESSED BY
WALL
5` 69 �-
INSPECTION RECORD d
O
U
i
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Plan check fee 25% of above. U
tu
PERMIT ISSUING FEE$ 5—DZ
TOTAL FEE p a
PLAN CHECK PLICANT
NAME
`- ADDRESS! .. .. -
CITY NO
_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PLICATION AND I -
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
r ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR r t
CONDITIONING. '
•1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS r DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE 1 p ,
OF THE STATE OF CALIFORNIA ROUGH •`,•��`�` ^ "` CIr /yy
SIGNATUREFINAL'S
v J�"•i•J i A �v 1!��`;
OF PERMITTE
PERMIT VALIDATION- cK'.. ,'J~M g.; 'CASH
PLAN CHECW VALIDATION CK MO CASH �w
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