HomeMy Public PortalAbout6443 GOLDEN WEST AVE_Mechanical__ 76 A364- CE ale- baaAP CATION FO ERMIT
HEATING - VENTILATING AIR CONDITIONING .`
COUNTY OF LOS ANGELES BUILDING a
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNS
(PRINT OR TYPE ONLY)
MAI L
NO. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS 0 �
CIT TEL. NO. b
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE 90. CLASS
VENTILATION SYSTEM D18TRICT NO. GROUP JONQ p EaaEo BY
EVAPORATIVE COOLER r O,-51
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FURNACE: FAU GRAVITY INSPHCTION RECORD
FLOOR BTU
HEATER: SUSPEND UNIT_
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Pla❑ check fQe 2596 of above. See reverse,
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PERMIT ISSUING FEE S s 00
TOTAL FEE AZp
PL CHECK APPLICANT
NAME
ADDRESS
CIT TEL.N0.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIB APPLICATION
AND STAT[ THAT THE ABOVE Il CORRECT AND AGREE TO COMPLY
WITH ALL ORDINAM C[D AND LAWS R[GULJITING HEATING, VENTI- AP PRO VALE DAT[ INS P[CTOR'l IIGNATU RE
LATING, AIR CONDITIONING.
RO UG K
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DI VI SIO OF E BUSINESS AND PROFESSIONAL FINAL ��
CODE OF TH[ 1 CALIF r""
SIGNATURE ERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE
PLAN CHECK ALIDATION CK. M.O. ` AI
DQ BACK OF APFLICATWIN FOR COMPLETE FEE SCHmULE