HomeMy Public PortalAbout9128 HERMOSA DR_Mechanical__ 76'A354 -EE BIB - 9-" APPLICATION FOR PERMIT
HEATING - VENTILATINrG, AIR CONDITIONING
COUNTY 0,F..LOS ANGELES BUILDING ?r :
DEPARTMENT OF COUNTY ENGINEER ADDRESS �
.•BUILDING_AND SA F ETY.,DIVI SION ,.�y iOCALITY /��• .r ?' K "'�"" "
.. .. < NEAREST
CROSS ST:�.•.....+4r?+.r-'.�.Flr-v7 r.,,,...d.,,,-�y„_. '
FOR APPLICANT TO FILL IN
(PRINT OR TYPE.DNLY.)...-
MAIL r'
•NO. TYPE OF APPLIANCE OR EQUIPMENT F,EE ADDRESS/.a.-:;f,,( .iTJ ^'�`.,..�Fr{(,.Y„LJ •✓wry./},i"-
.. .4 i d' r "•, CITYt' x r: •I! TEL:-N / JBY
'ABSORPTION UNIT; BTU : CONTRACTOR` rz
AIR HANDLINGUNIT, CFM �ADDRESS dBOILER, BTUCOMPRESSOR BTU j "'" ".✓ S ATE / LIC
LICENSE.NO.fyhC/4 // / CLASSVENTILATION SYSTEM - DISTRICT No. GROUP ZONE / PROCEy
f EVAPORATIVE COOLER .J - Sf' ' Y Cf ppl1lr V
'FURNACE: FAUGRAVITY
FLOOR e U �• rT f - INSPECTION RECORD ' '.1 • LL
HEATER: SUSPENDEDUNIT
WALL
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1al. check fee 25° of above. See reverse. - -
i. PERNIIT.ISSUING,F,.EE S. ..�,3- ••oD - - -
TOTAL FEE,. J
PLAN,CHECK APPLICANT „I-
NAME _
ADDRESS
CITY'• -�•TEU!NO d. rROUGH,.
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I THEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH-ALL ORDINANCES ANO-LAWS _REGULATING HEATING, VENTI ” !'DATE'17 L:INSPECTOR'S SIGNAMRIEL'ATINS, AIR CONDITIONING, e ,. h_ :laq.-.:_I HEREBY CERTIFY,7THAT I'AM NOT ACTING IN VIOLATIONOFCHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONALCODE OF.THE STATE OF-CALIFORNIA.SIGNATURE . r/'- .% MIT VALIDATION, cK. M.0. CASH
OF PERMITTEE-F✓' . , wY-
PLAN CHECK VALIDATION � - �I
'C K. M,O, CABH f H ` .�
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SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE '