HomeMy Public PortalAbout9240 KEY WEST ST_Mechanical__ /?
76 A364- CE 818- 5-73
APPLIC ON FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS 410DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY `
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER `1�
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY <� TEL, NO CMI `U3 ,
e
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
CITY TEL. NO
COMPRESSOR, BTU STATE LIC
LICENSE NO., CLASS
VENTILATION SYSTEM DISTRICT No GROUPoNe, ssED BY
EVAPORATIVE COOLER �j D // 7 f}
FURNACE. FAUGRAVITY •lam -
FLOOR BTU INSPECTION RECORD
HEATER SUSPENDED UNI
WCL 6 a - J j,( GAJ
0
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C/J
Plan check fee 25% of above See reverse z
PERN'IIT ISSUING FEE S s 00
TOTAL FEE 0
PLAN CHECK APPLICANT
NAME
ADDRESS -I
CIT . TEL NO 2Mr'093s'
I HEREBY A KNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING
ROUGH
CHAP
HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION q-
OF �
OF HAPTER S9, DIVISI N C3, OF THE BUSINESS A D PROFESSIONAL FINAL
CODE OF THE TATE 0 ALIFORNIA
SIGNATURE
OF PERMITTEE ERMIT VALIDATION CK M 0 CASH
PLAN CHECK VALIDATION CK M o CA H
4 6 29 41 0 8.0 0 A� 3
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