HomeMy Public PortalAbout5426 GOLDEN WEST AVE_Mechanical__ 76 A364 - CE 818 -1!75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
4* o 'i i + '�
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY Timiae mu.
NEAREST
[CROSS ST.
FOR APPLICANT TO FILL-IN OWNERf [
(PRINT OR TYPE ONLY)
MAIL
No TYPE&SIZE OF EQUIPMENT FEE ADDRESS 142 %jAnJIS JAnO
SEE BACK OF APPLICATION
+� r� CITY TEL. NO.
d FORCE AIR FURNACE, BTU I Q. Arm n
CONTRACTOR11�s$ �*
COMPRESSOR, BTU "&6? k + 10100
ADDRESS n2 ,Borth Lwo
VENTILATION FAN e��f r�
CITY TEAzum L. NO. %r/
LIST ALL OTHERS BELOW STATEr�g� LIC.
LICENSE NO.Z -T CLASS
PIS7RtCT NO. GROUP :ONE I PROCESSED BY
}
IL
INSPECTION RECORD O
U
W
J
L
}
tr
Q
O
tL
Ui
Plan check fee. See reverse.
F'f.R�ill 1�tiIl1C Ef�F; 00
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,-VENTI- APPROVALS DATE. INSPECTOR'S SIGNATURE
LA71NG, AIR CONDITIONING.
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION --
OF CHAPTER 9, DIVISION 3. OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF CALIFORNIA. h4v
SIGNATURE ,PF,,RM�LT VALIDATION -K. M.o. .r,AS-.
OF PERMITTEE - �
PLAN CHECK VALIDATION CK. M.O. CASH' I • r °