HomeMy Public PortalAbout5112 GOLDEN WEST AVE_Mechanical__ 7t4A"4%4a1 'Y!'"-1r" APPLICATION FOR PERMIT
IF HEATING' - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELS$
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DNISION
FOR APPLICANT TO FILL IN. Bu
(PRINT OR TYP.E ONLY) ADDRESS
-71
NO. TYPE OF ARPLJANCE OR EQUIPMENT, FEE
NEAREST
CROSS ST. �J
ABSORPTION UNIT.BTU 'OWNER ,
AIR HANDLING UNIT,CFM MAIL .
ADDRESS
BOILER,BTU 'CfTY TFL NO.
COMPRESSOR BTU �Q CONTRACTO
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL N
FURNACE: FAU_G V STATE LJC.
FLOOR BTl7 LICENSE NO CLASS
HEATER: SUSPENDED-UNIT- DMTRJCT NO.' ZOME ED BY
WALI
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INSPECTION RECORD
Plan check fee 25% of above:
PERMR ISSUING FEE.$
TOTAL FEE
PLAN CHECK APPLLCANT- '
NAME
ADDRESS
CITY TEL NO.
]THEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPfJCATION AND
STATE THAT THE ABOVE 45 CORRECT AND AGREE TO COMPLY WITH AL .
ORDINANCES AND LAWS .REGULATING HEATING. VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY AW NOT ACTING IN VIOLATION OF ��'u-` DATE 00PECTOWS$n RE
CHAPTER 9 ION OF THE USIN PROFESSIONAL ODE ROUGH '
OF TjiE O ORNLA. •'
SIG FINAL
OF PERM nTE _
PLAN E VALIDATION cK iso. CASH PERMIT VALIDATION CK Wo. CASH
"DAUG BS .4,4- *1 2 Y-0 0