HomeMy Public PortalAbout8621 HALDEMAN ST_Mechanical__ 76 A364 - CE 813 - 9-71 APPLICATION FOR PERMIT
HEATING - VENTILATING AIR CONDITIONING
COUNTY OF LOS ANGELESBUIL+DING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY �� C �-G TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR L�yvf
AIR HANDLING UNIT, CFM - ADDRESS
BOILER, BTU CITY -� TEL. NO. O '9 19gf/7
COMPRESSOR, BTU /0100 (�0
STATE LIC
LICENSE NO. Y/ 8 CLASS C-ao
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE FAUS_GRAVITY INSPECTION RECORD c�
FLOOR BTU D !1 tr
HEATER: SUSPENDED UNIT_ o
WALL v
LIJ
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Plan check-fee 257. of above See reverse.
PERMIT ISSUING FEE $ 3 00
TOTAL-FE'E 100
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
LATING, 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 w'
SIGNATURE PERMIT VALIDA I ISICK. M 0, - CASH
OF PERMITTEE
PLAN CHECK ALIDATION CK M 0 CASH
.00-Sf Ptf'
00 8 .273 -W.R 2 0 4 1 A 1 3,00-
SEE
EE BACK OF APPLICATION FOR COMPLETE F_EE SCHEDULE ,