HomeMy Public PortalAbout8854 HERMOSA DR_Mechanical__ CE-8181RE V.6/]8)
Z APPLI TION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING (Ci
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(PRINT OR TYPE ONLY) ADDRESS
LOCALITY L L\ T
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER `�
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER, BTU CITY TEL.NO..
COMPRESSOR.BTU CONTRACTOR ( *c—
VENTILATION SYSTEM ADDRESS ,S� It/,, `S 1 7
EVAPORATIVE COOLER CITY /Y '5e rr</f TEL.NO.
FURNACE: FAU OR I -Y /( I STATE / 'J LIC.
FLOOR— BTU (/ LICENSE NO. /7 (� CLASS14 —2�
HEATER: SUSPENDED—UNIT— APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH Y
FINAL L- b
INSPECTION RECORD G>
asO
F�
Plan check fee 25% of above.
PERMIT ISSUING FEE; - Z
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL.NO. :9 G L o c n
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND J V O.U fl
STATE THAT E ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL # e e o e 4
ORDINANCE 0 LAWS REGULATING HEATING. VENTILATING. AIR
CONDITIONI.G. PERMIT VALIDATION 2'0 0
I HERE Y EPLEY T(re�^^T 'NOJA TING IN VIOLATION Of 2 7.Q
CHAPTER 4 ION 3. OF\UfE B NES NO O SBIONA O
CH THE STATE
TE IO - R IA 0 0 0 270050
SIGNATURE
OF PERMITTEE o7.24-79
DISTRICT NO. KOCESSED Y
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