HomeMy Public PortalAbout9568 KENNERLY ST_Mechanical__ 76A364E(CE-818A)-9/77 APPLICATION FOR .PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN t
UILDING
(PRINT OR TYPE ONLY) DDRESS
OCALITYNO TYPE OF APPLIANCE OR EQUIPMENT FEEEARESTROSS ST
ABSORPTION UNIT BTU
OWNER DA Au
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER,BTU CIT i TEL NO
COMPRESSOR,BTU CONTRACT R t
VENTILATION SYSTEM ADDRESS '
,EVAPORATIVE COOLER CITY, TEL NO
FURNACE FAU_GRAVITY STATE LIC
FLOOR BTU LICENSE NO CLASS
HEATER SUSPENDED UNIT- DISTRICT NO
GROUP zoN ocESSEORv
WALL D �/ V
INSPECTION RECORD
V
IN
O
Plan check fee 25% of above
PERMIT ISSUING FEE$ r7 p O Z
TOTAL FEE Q
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALLkROUGH
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING AIR
CONDITIONING
I HEREBY CERTIFY,THAT I AM NOT ACTING IN VIOLATION OFVALS DATE INSPECTOR SSIGNAT RE
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OFCALIFORNIA fl
SIGNATURE • "/
OF PERMITTEE
PLAN CHECK VALIDATION CK Mo CASH PERMIT VALIDATION' c Mo CASH
1
4 7 3 JUL- 5.41 0