HomeMy Public PortalAbout6137 IVAR AVE_Mechanical__ 76 A364 - CE 818-1/75 _
APPLICAY!®N. FO.R PERMIT
HEATING -"VENTILATING - AIR CONDITIONING �.
COUNTY OF LOS ANGELES BUILDING t t✓
DEPARTMENT OF COUNTY ENGINEER ADDRcSS �✓
BUILDING AND SAFETY DIVISIONrLOCALITY T
NEAREST
Ll
CROSS ST.
FOR APPLICAN.T -TO FILL IN ,.,i OWNER
(PRINT OR TYPE ONLY) -
MAIL '
No TYPE&_SIZE OF EQUIPMENT FEE ADDRESS 14 /
3'
- SEE BACK OF APPLICATION
CITY ,�o--i.� - p ,
L CiLci TEL. NO,
FORCE AIR FURNACE, BTU
CONTRACTOR `
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN CITY!/ TEL7
�/(Zr � ty . NO.
LIST ALL OTHERS BELOW I
LICENSE NO. .9✓ ��/ ,7_ CLASS. 15 1
I �J�1QPI STRICTgN O/� GROUP ZONE CESS ED BY
V l `
INSPECTION RECORD
O
U
N
U
LI
N'
Plan check fee. See reverse: z
1
PLAN-CHECK APPLICANT
NAME
ADDRESS
CITY d (f 'TEL.N0. � 'For
I HEREBY AC KNOWLEDGE THAT I-HAVE READ THIS APPLICATION
'AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY .
WITH .ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- - APPROVALS DATE INSPECTOR'S SIGNATURE
EATING, AIR'CONDITIONING. ..
ROUGH
I- HEREBY CERTIFY THAT I AM NOT ACTING INVIOLATION'
OF CHAPTER 9, DIVISION OF THgE]BUSINESS AND.PROFESSIONAL FINAL
"CODE OF THE STATE OF `�F0, I• ,r,-
SIGNATURE +�!////] 4` PERMIT VA LIDATLON CK. M.0 CASH
OF PERMITTEE
.PLAN,CHECK VALIDATION CK. M.0. CASH
. i QV �