HomeMy Public PortalAbout6241 HART AVE_Mechanical__ 7W64C
CLQ-818'(REV.11/78)
®: APPLICATION FOR PERMIT
HEATING - VENTILATING AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AN®SAFETY
FOR APPLICANT TO FILL IN ADDRBUILDING 6z
ESS
(PRINT OR TYPE ONLY) `
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE `
NEAREST
CROSS ST. L
ABSORPTION UNIT,BTU '
1 �d
OWNER
-_.
AIR HANDLING UNIT,CFM MAIL_, _� `•-•
ADDRESS 1
BOILER,BTU CITY r1 I'ra C TEL.N •,
COMPRESSOR.'BTU CONTRACTOR C,
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITY l TEL.N
FURNACE: FAU GRAVITY STATE LIC. 'l
FLOOR' BTU Q' LICENSE NO. CLASS G 1GO
HEATER: SUSPENDED IT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL a '�+�- '7q —
ROUGH 6 Z/% �•
FINAL
0
INSPECTION RECOR& g�
Plan check fee 25% of above. 9L
vA
PERMIT ISSUING FEE$ 7 0'D z
TOTAL FEE
PLAN CHECK APPLICANT - PLAN CHECK VALIDATION
NAME -
ADDRESS -
CITY TEL.NO.
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL _ r2'6 27,4 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION # o o'o o 4 1
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF '
CHAPTER 9, DIVISION 3. OF THE BUSINESS AND PROFESSIONAL CODE 2i0 0 2 7,Q O
OF THE STATE 0 LI RNp.
SIGNATURE _ 1 ,r]�7, V
O (';U
OF PERMITTEE O O O 2 1
DISTRICT NO. PROCESSED BY Q a 2'2,_,7 9