HomeMy Public PortalAbout5801 GOLDEN WEST AVE_Mechanical__ 76 A384' CE 818-1/75 +
APPLICATION FOR PERMIT �yy Lac,
HEATING - VENTILATING - AIR CON0111,0NING
COUNTY OF LOS ANGELES TAR
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION,
FOR APPLICANT TO' FILL IN OWNER
(PRINT OR TYPE ONLY) MAIL
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,NO TYPE&SIZE OF EQUIPMENT- FEE ADDRESS' - -
SEE BACK OF APPLICATION - f
O 'CITY TEL. NO.
FORCE AIR FURNACE, BTU
COMPRESSOR, BTU CONTRACTOR 2 �� �.,5 ADDRESS 22 vV
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VENTILATION FAN CITY TEL. NO Z7
LIST ALL OTHERS BELOW STATE LIC
LICENSE NO. -Z_-0 Z 7v . CLASS • _Z�
Iy R T NO GROUP ZONE PROCESSED BY
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INSPECTION RECORD
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Plan check fee. See reverse. t7
PF1011 I- Iti5U1\G FLI' s
PLAN CHECK APPLICANT
NAME .
ADDRESS
CITY TEL-NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENI- APPROVALS DATE INSPECTOR'S SIGNATURE _
LATING, AIR CONDITIONIVENT
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ROUGH
I HEREBY CERTIFY THAT I AM N ACTING INS VIOLATION
OF CHAPTER 9, DIVISION 3, F T S ESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF C OR IA
SIGNATURE P. MIT V
OF PERMITTEE ALIDATION• c o CASH -
,
PLAN CHECK VAL " ATION CK. M o CASH
� � 5, BSEP 104 -1 23.25AW