HomeMy Public PortalAbout4935 HALLOWELL AVE_Mechanical__ 76 A364 - CE B18-1/75
APPLI ION FOR PERMIT
HEATING - VEN •ILATING - AIR,CON,D-I1'IONING,'
COUNTY OF LOS, ANGELES BUILDING"
DEPARTMENT OF COUNTY ENGINEER"" ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST _
CROSS ST...
FOR APPLICANT.'TO FILL-IN F OWNER,
•, (PRINT OR TVPE'ONLY) -
MAI L
NO TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION - - -
CITY._ ? "- :TEL. NO.'
FORCE AIR FURNACE, BTU
CONTRACTO G
COMPRESSOR,,BTU .
ADDRESS ' 0�
r
VENTILATION-FAN
CITY57
LIST ALL OTHERS BELOW STATET" y L'IG. �^
LICENSE NO. :CLASS l� 26
DISTRICT NO. GROUP. ZONE CESSED BY
INSPECTION-RECORD
0..
y° O
O
Plan check fee. See,reverse., - z-
PI:Ii\,11T ISSI;I\G 171';l•: S•
PLAN CHECK•APPLICANT r ,
NAME `
ADDRESS
CIT-Y TEL NO.
I HEREBY ACKNOWLEDGE THAT J-HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY _ Lm
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,•VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LAYING. AIR CONDITIONING - _
ROUGH .7
I-HEREBY CERTIFY THAT i AM. NOT ACTING IN VIOLATION.
OF CHAPTER, 9, DIVISION 3, THE BUSINESS AND PROFESSIONAL' FINAL
CODE OF THE STAT OF FORN• -
SIGNATURE PER-MIT-VALIDATION- CK. M 0. CASH
•OF-PERMIT.TE _ , A, ,, ;-, --' ,•
PLAN CHECK VALIDATION CK., MIO CASH p. q- N -}}
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