HomeMy Public PortalAbout6206 GOLDEN WEST AVE_Mechanical__ 76 A364•-.EEzlB - 9-71 APPLICA ON F_0R PERMt'T
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS
FOR APPLICANT TO FILL IN Ow Et
(PRINT OR TYPE ONLY)
MAI L
NO TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY -TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
CIT TE NOd �r f
COMPRESSOR, BTU 6v STATE L{C n Vpp��
LICENSE,NO. �' ` CLASS C OS
VENTILATION SYSTEM DISTRICT NO GROUP ZONE l P ESSED BY
EVAPORATIVE COER �j� g C
% FURNACE: FAUGRITY `J C:)FLOOR BTU C7 DO INSPECTION RECORD
HEATER. SUSPENDED UNIT_ C>
WALL C.)
Lu
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S 3 00
TOTAL FEE DO
PLAN CHECK APPLICANT
NAME 4
ADDRESS
CITY TEL NO
1, 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 IN ECTOR'S SIGNATURE
LATING, AIR CONDITIONING
ROUGH
I HEREBY CE Y THAT I AM NOT ACTING I IOLATION
OF CHAPTER 9, VIS N 3, OF THE USINESS AND ESSIONAL FINAL 7
CODE OF THE S TE ALIFORNI --
SIGNATURE PERMIT VALIDATION C M 0 CASH
OF PERMITTE
PLAN CH VA L-f DATION CK M O CASH
nt' 2963'r3� AUnG241 D 13.0 -0e
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE