HomeMy Public PortalAbout6249 KAUFFMAN AVE_Mechanical__ 76 A364- CE.818- 5-73 6l �'( lfl9 Mlq•"°�"AN llltaq��i
APPLICATION FOR PERMITt
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF,LOS ANGELES ADDRESS licl'! 404—
BUILDING
OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY 'Yh 1 C
11+1
NEAR EST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER 'i_,{) �� 1
(PRINT OR TYPE ONLY) ` } IJQ
MAIL
NO. TYPE•OFAPPLIANCE OR-EQUIPMENT FEE ADDRESS 5 p�J�
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR ^� C
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITYSQ �" TEL. NO.a83 qlg)
r® COMPRESSOR, BTU STATE ` LI C.
LICENSE NO. 01 CLASS
• , i 1y (vbe�
VENT ILATIO SYSTEM DISTRICttT��NO. GROUP /ZONE PROCESSED Y
EVAPORATIVE COOLER �✓ Liv �'
EURNACE: FAU GRAVITY +yQ -7C INSPECTION RECORD
FLOOR BTU /C/ �3
HEATER: SUSPENDED-UNIT-
WALL
USPENDED UNIT_ �IOuG O� JN
WALL O� v+
aap —ft 3 a ry�p �
—l ao eoo - moo d� 4_ l�oN6 L,111,17- c oc 7jte%/s o
0
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S �o
TOTAL FEE f
PLAN CHECK APPLICANT
ii
NAME-f �Yrl 1 NCS
ADDRESS
CITYSC, �L TEL.N0,1�3 -q�V
I -HEREBY ACKNOWLEDGE THAT 1 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 INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING. -
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DI ISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
.CODE OF THE ST I
A '
SIGNATURE PERMIT VALIDATION CK. M'.0. CASH
OF PERMITTEE j _. 9
PLAN CHECK. VALIDATION. CK. M.0. CASH
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE