HomeMy Public PortalAbout5239 KAUFFMAN AVE_Mechanical__ 76 A:364 CE BIB -1/75
-APPL AT�ION "FOR PERMIT
i HEATING - VENTILATING - AIR CONDITIONING
COUNTY'OF LOS ANGELES BUILDING A!--
DEPARTMENT OF.COUNTY ENGINEER ,
ADDRESS 3 A/41 i
BUILDING AND'SAFETY DIVISION LOCALITYyy� I
NEAREST
CROSS-ST.
FOR APPLICANT TO FILL IN - OWNER. '
(PRINT OR TYPE ONLY) I - ,
MAIL /
NO. TYPE-'&_517E OF EQUIPMENT FEE' ADDRESS: Z k f �qN
-'SEE BACK OF APPLICATION
CITY �e W TEL, NO,
FORCE,AIR FURNACE,-BTU 6 D r
CONTRACTOR e
COMPRESSOR, BTU J
ADDRESS Z AJ - .
VENTILATION FAN
CITY TEL. NO. �3- 30
LIST ALL OTHERS BEL-OW LICENSE NO. 3/Z S7 CLASS Z�
I RI T NO. GROUP ZONE P SSED BY
Y INSPECTION RECORD
(L
U
O
-r W
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Plan check fee. See.reverse.- z
1'I11011`I' lS.M' \G PEF: S
PLAN CHECK APPPLICANTd
NAME LaV� S"E�° M 4-M4 L
ADDRESS a'3 Z Cec Dip. "
CITY, / TEL NO.333 f
IH
N
EREBY A OW,LEDGE THAT HAVE READ THIS APPLICATION }_ '
AND STATE THAT THE,-ABOVE IS CORRECT-AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING.HEATING, VENTI- APPROVALS DATE.,' INS PECTOR'S SIGNATU RE '
LATING, AIR CONDITIONING. - '
ROUGH
I HEREBY.CERTIFY THAT 1 AM NOT ACTING IN VIOLATION --
OF CHAPTER 9, DIVISION 3, O THE BUSINESS AND PROFESSIONAL FINAL
CODE OF'THE STATE OF CAL RNIA.
SIGNATURE PERMIT VALIDATION - M.O. CASH
OF PERMITTEE
PLAN CHECK' VALIDATION CK; M.0. CASH
y 3.6..2 �Y• 18 4,3 -A- 1 9.5-Q'A
•76 A364 - CE BIB - 9-71 ppp pTION FO ERMIT
HEATING - VENTILATING - IR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
I',
ROSS ST.EAR EST &LA-C -,v-
FOR APPLICANT TO FILL IN OWNER �+ � /r
(PRINT OR TYPE ONLY) a
MAIL /"
��//
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS o? 3 / hO
CITYe7yl /r C�/ TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS 3 a C �2
BOILER, BTU
,.., ' CITY pN� �j�y� S TEL. NO.333 -O 3O7
COMPRESSOR, BTU SATE v LICE SE NO. ��S/ /� CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONEaESSED Br
EVAPORATIVE COOLER (JQ � 4
FURNACE: FAU GRAY TYFLOOR BTU d000 INSPECTION RECOR
HEATER: SUSPENDED UNIT - .a-
WALL
/ 'w
a.
Plan check fee 25% of above. See reverse.
Ogg PER\i lIT ISSUING FEE
TOTAL FEE
PLAN CHECK APPLICANT �L
NAME 1_4VIIE Q� t
ADDRESS .;2 3 3 e Q 2es�—fi e ,
CITY '7.,4e/�Ai dA- W7. TEL.NO.333 -7-9�
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
'LATING, AIR CONDITIONING.
' ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL -ZS-fig
CODE OF THE STATE OF CA FORNIA
SIGNATURE
IPERMITTEE 2 PERMIT VALIDATION CK? M.O. CASH
m dL"l
PLAN CHECK VALIDATION CK. M.O. CASH
2.2y.04-1MAY 11,-43 4.5:0 Ak
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE O