HomeMy Public PortalAbout5435 GOLDEN WEST AVE_Mechanical__ 76A36tE itE-81SA)-9/77 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
ty► of 'e"I'Ie city UC .
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION F
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESSLot -
LOCALITY 4D e
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
CltZ
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU �A
OWNER 4.>«se
AIR HANDLING UNIT,CFM MAIL 23 y �e
ADDRESS J"P
BOILER,BTU CITY la TEL.NO.
COMPRESSOR, BTU fhb' CONTRACTOR
VENTILATION SYSTEM ADDRESS 71P Uorth Loxwi
EVAPORATIVE COOLER CITY AZUSA TEL.NO. .r
q FURNACE: FAU GRAVITY STATEa� LIC. Y
3. FLOOR BTU ^' !3't LICENSE NO. 2V373 CLASS yl+w
N'
HEATER: SUSPENDED UNIT- DISTRICT NO. GROUP ZONE PROCESSED BY
WALL
w'F
INSPECTION RECORD u
W
J
?Ian check fee 25% of above.
PERMIT ISSUING FEE tXl 136O
TOTAL FEE .fes
W
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
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. 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 -41 FINAL
OF PERMITTEE
.,
PLAN CHECK VALIDATION CK. MO. CASH PERMIT VALIDA 1 N CK. M.O CAS
`,4 s s x
1 r.
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