HomeMy Public PortalAbout5411 GOLDEN WEST AVE_Mechanical__ 76A364E(CE-818A)-9/77 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
;11ty of I19ty ac.
COUNTY OF LOS ANGE ES
r - iDEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIO
FOR APPLICANT TO FILL,INADDRESS { t BUILDINGs
(PRINT OR TYPE ONLY)
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY Yewle
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU OWNER 1y
egmqd
AIR HANDLING UNIT,CFM AMAIL DDRESS 4?
.5 '50,lmde law
BOILER,BTU CITY ArOndirt TEL.NO.
COMPRESSOR,BTU of00 CONTRACTORB1t=,e8 r, . . y
VENTILATION SYSTEM "JUJ d ADDRESS
EVAPORATIVE COOLER CITY AZUssm TEL.NO. -1 .673+
^g FURNACE.: FAUX GRAVITY STATE ] LIC. h
FLOOR BTU LICE
'>` 6, NSE NO. .Ji CLASStt
HEATER: SUSPENDED UNIT- DISTRICT NO, GROUP ZONE PROCESSED BY
WALL
a
INSPECTION RECORD Lu
18J
J
U
Plan check fee 25% of above.
PERMIT ISSUING FEE$ `'` O
m.
TOTAL FEE fir;
Lu
o--
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, VENTILATING, AIR /
CONDITIONING.
I HEREBYCERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CALIFORNIA. ROUGH
SIGNATURE
OF PERM ITTEF -^f^" FINAL Am 41
PERMITVALIDAT O cK MO CA
PLAN CHECK VALIDATION CK. M.O. CASH
� P t
�5