HomeMy Public PortalAbout10673 HALLWOOD DR_Mechanical__ 76 :_-C` @IB - 9-71 APPLI TION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING 3 �
0
COUNTY OF LOS ANGELES BUILDINGG, j
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DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY T& f
NEAREST
CROSS ST. d
FOR APPLICANT TO FILL IN OWNER ��••
(PRINT OR TYPE ONLY) �` _ V
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS C�
CIT TEL. NO. �� C-i3�
ABSORPTION UNIT, BTU
CONTRACTOR 1 --A.- F, r . !C6 ,
AIR HANDLING UNIT, CFM
ADDRESS G'
BOILER, BTU t
CITY I C C I TEL. NO.
i COMPRESSOR, BTU U STATE (� LIC.
LICENSE NO. . `' O CLASS
- .a J
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE �ms SED BY
EVAPORATIVE COOLER
f FURNACE: FAUGRAVITY V
FLOOR BTU @2-06 7 0INSPECTION RECORD
HEATER: SUSPENDED UNIT_ o�
WALL Luv
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S,, 3 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATETHAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ,ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTO 'S SIGNATU, E
LATING, AIR CONDITIONING. ^
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION ROUGH
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL a FJ
CODE OF THE STATE OF CALIFORNIA.
SIGNATURE _. i Z9 PERMIT VALIDATION C K V M.0. CASH
OF PERMITTEE / ,J?LS-ii: d".e pra6L-
PLAN CHECK VALIDATION CK. M.O. CASH
t)r OV 6 4 1 01 3.0
/ - f M
SEE BACK OF APPLICATION FOR COM PLETE FEE SCHEDULE