HomeMy Public PortalAbout6201 KAUFFMAN AVE_Mechanical__ 76A364C
CE-818(REV.6/78)
;Ps APPLICATION FOR PERMIT
HEATING — VENTILATING — AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
LOCALITY
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. -
C COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER
CITY TEL.NO...,
FURNACE: FAU = GRAVITY STATE LIC.
FLOOR BTU LICENSE NO. - CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
ROUGH ao
FINAL
U
W
' J
INSPECTION RECORD U.
Plan check fee 25% of above.
O
PERMIT ISSUING FEE$ �
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING. AIR
CONDITIONING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE
..OF THE STATE OF CALIFORNIA.
SIGNATURE
OF PERMITTEE
DISTRICT NO. PROCESSED BY
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