HomeMy Public PortalAbout9625 GARIBALDI AVE_Mechanical__ CM a18(R V.6/78) '
m� APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING ADDRESS -5 .
` (PRINT OR TYPE ONLY)
LOCALfTY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST. .
ABSORPTION UNIT,BTU
OWNER • -
AIR HANDLING UNIT,CF-MAIL
.
ADDRESS
BOILER,BTU - CITY Jr- TEL NO.
COMPRESSOR,BTU CONTRACTOR G�
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER Cn'Y TEL NO.
FURNACE: FAU G V STATE LIC.
FLOOR ' BTU, LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE I KSF E CTO R'S S n NATU RE
WA
ROUGH
FINALZ12, 0
INSPE ION RECORD L7
Plan check fee 25% of above.
PERMff ISSUING FEE$
TOTAL FEE Z
PLAN CHECK APPLICANT P -I jECK7V/A/LI/DATION
NAME 4v�C. �GClf7(
ADDRESS
CnY TEL NO. '
�.7.o a 1 A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND # o o,o o 4 1
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR ;2 0 - 27,00
CONDITIONING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION or '010 0 2 7.0 0 6
CHAPTER 9DIVLSION 3,,0 TH BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF C.4JF IA. I lA n 05—7 9
SIGNATURE
OF PERMITfeC
DISTRICTNOO. P PSSFD