HomeMy Public PortalAbout10122 LA ROSA DR_Mechanical__ ]B A354 - CE 918 - 9-7I l APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS �l
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY,
NEAREST
CROSS ST. l
FOR APPLICANT TO FILL IN OWNER 14/�
(PRINT OR TYPE ONLY) R
MAIL
NO. TYPE OF APPLIANCEOR EQUIPMENT FEE ADDRESS
ABSORPTION UNIT, BTU CITY TEL. NO.
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS r .7
BOILER, BTU
CITY J� _ ! TEL. NO.��♦- j2l�
COMPRESSOR, BTU - fod
E K(� LIC. JJNSE NO. [, CLASSVENTILATION SYSTEM msTRICT No. GRouP zoNEEsseo BYEVAPORATIVE COOLER wyFURNACE: FAU—GRAVITY
FLOORBTU INSPECTION RECORDHEATER: SUSPENDED_UNIT_WALL
Plan check Fee 25" of above. See reverse.
PERMIT ISSUING FEh, $ S TOTAL EEE /3
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL OROINAN CES AND LAWS REGULATING HEATING, VENTI- APPROVALS BITE IN ECTOR'S SIG T E
LATING, AIR CONDITIONING. ROUGH
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF C� ORN
SIGNATURE PERM]T`V <K.LDATI N M.O. CASH
OF PERMITTEE i
PLAN CHECK VALIDATION CK. M.G.
CASH
�F ,n104 441 D 1 3.00- F
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE