HomeMy Public PortalAbout9234 KEY WEST ST_Mechanical__ 76 A364 - CE 81 8-1/75
APPLICATION FOR PERMIT
HEATING -.VENTILATING - AIR CON0I1'IONING
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY c,r9`)/
NEAREST
<CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE&SIZE OF EQUIPMENT FEE ADDRESS (,(�
SEE BACK OF APPLICATION -
CIT TEL. NO
FORCE AIR FURNACE, BTU
CONTRACTOR
COMPRESSOR, BTU
ADDRESS
VENTILATION FAN CITY TEL. NO.
IST ALL OTHERS BELOW STATE LIC.
LICENSE NO. CLASS
~ DISTRICT NO. GROUP ZONE PRO C SED BY
INSPECTION RECO D
0-
0
U
O
H
U
W
d
N
Plan check fee. See reverse.
Z
1.0TA1, Fli:
PLAN CHEC PLI CANT
NAME
ADDRESS
CITY TEL.NO.
4
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, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LAT ING, AIR CONDITIONING.
ROUGHe
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE
SIGNATURE PERMIT VALI AT CK. t .O. 'CASH
SI PERMITTEE
PLAN CHECK VALIDATION CK. M.0. CASH
1.6 '91,-'JUN 2-3 -41 ID 1 .5.0 0 ��: