HomeMy Public PortalAbout5342 GOLDEN WEST AVE_Mechanical__ y A364- CE.818-1/75
APPLICATIO OR PERMIT
HEATING - VENTILATING - AIR CONDITIONING.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS � J
BUILDING AND SAFETY DIVISION LOCALITY ' ,
NEAREST +
CROSS ST
FOR APPLICANT TO'FILL'IN OWNER
(PRINT OR TYPE ONLY)
MA
NO TYPE&SIZEOF'EQUIPMENT FEE A D S
SEE BACK-OF APPLICATION
CITY TEL N2W6 Z�U
FORCE AIR FURNACE, BTU
CONTRACTO f "
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN CITY TEL. NO
fJ /
LIST ALL OTHERS BELOW STATE -7 l LIC
1. LICENSE NO. ! - CLASS ;C`=2�,
GROUP ZONE �/ROESSED BY
INSPECTION ECO RD
n.
O
_ U
O
H
W
d
Plan check fee. See reverse.
PI''H1I1'I' ItiSI l\G F'1';I. S 3 00
101 ,\I, F I:I. Poo
PLAN CHECK APPLICANT
NAME -
ADDRESS
CITY TEL NO
" a
I
'•IHEREBY 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 INSPECTOR'S SIGNATURE
LATING,'AIR CONDITIONING
ROUGH•
I HEREBY CERTIFY T T I A NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION OF TH BUSINES PROFESSIONAL FINAL
CODE OF THE S1TATE L OR
SIGNATURE PERMIT VALIDATION CK M'0' CASH
OF PERMITTEE _
,PLAN CHECK VAL ATION CK M D CA H
8,3 04.4;1:-�" " . I .78.0'0 e98