HomeMy Public PortalAbout9843 KEY WEST ST_Mechanical__ 76A364 - CE818 _"3-69
APPLICATION FOR PERMI
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W JENKINS,SUPERINTENDENT OF BUILDING NEAREST.
CROSS ST
FOR APPLICANT TO FILL IN
OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY T N
AIR HANDLING UNIT, CFM CONTRACTOR/�
BOILER, HORSEPOWER ' ADDRES �/
CITY TEL NO
COMPRESSOR, HORSEPOWER STATE / LIC
LICENSE NO 4j CLA
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PR CESSED BY
EVAPORATIVE COOLER
FURNACE FAU GRAVITY
INSPECTION RECORD
FLOOR BTU
HEATER SUSPENDED UNIT
WALL >
O
U
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O
H
U
w
a
NEW_ADDITIONk PERMIT $ 3 00 z
ALTER---REPAIR_ TOTAL FEE $
PLAN CH P P L I C A NY'
NAME
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO,COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATfNG,.VENTI-
LATING, AIR CONDITIONING. APPROVALS _ DATE INSPECTOR'S SIGNATURE
I HEREBY CERTIFY THAT AM NOT ACTIN IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3, HE BUSINES N ROFESSIONAL FINAL /
CODE OF THE STATE OF C IF RNIA.
ep
SIGNATURE • JACK R ALLEN, SU RVIS ING MECHANICAL ENG'R
OF PERMITTE
PERMIT VALIDATION CK. M.O. CASH �
PLAN ALIDATION
I At',r 5 9.45 4c-- •,AUL21 4 1 D
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE