HomeMy Public PortalAbout5333 GOLDEN WEST AVE_Mechanical__ � F 76 �
A T E'( ag;�) g/" ,
APPLICATION 0 R PERBAITF` ,
-. HEATING - VENTILATING,, AIR CONDITIONING
COUNTY OF LOS ANGELES
.DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING ,
ADDRESS
(PRINT OR TYPE ONLY)
LOCALITY
NO TYPE�OF APPLIANCE OR EQUIPMENT FEE
NEAREST /a ,
CROSS ST
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER;BTU, CITY, TEL NO
COMPRESSOR,BTU I /}�� /
`v� �v' CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL NOFURNA //��ff ��,11
/ STATE LIC
FLOORCE FAU BTUG�QAVa;C,a LICENSE NO 3a.�q y CLASS(-��/
HEATER SUSPENDED C� UNIT— DISTRICT NO GROUP ZONE PRO ESSED BY
WALL �a^�
INSPECTION RECORD !
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Plan check fee 25% of above marh�
PERMIT ISSUING FEE$ —J-0-0 a V
TOTAL FEE 7 eZ
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBYL�CHAPTER
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
T THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ,
ES AND LAWS REGULATING HEATING, VENTILATING, AIR
ING —
EBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF / APPROVALS DATE INSPECTOR S SIGNATURE
9, DIVISION F THE BUSINES AND FESSIONAL CODEROUGHTE A NIA ' FINAL
PLAN CHECK VALIDATION CK Mo CASH, PERMIT VALIDATION ` CK Mo CASH
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