HomeMy Public PortalAbout10226 LA ROSA DR_Mechanical__ 76A369E ICE-B1BAI. I1/76 APPLICATION FOR PER
HEATING - VENTIIATI�dG - AIR ON ITIONhNG
COUNTY OF LOS ANGELES C/ O
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING 10226 U ROSA DR. . ,
(PRINT OR TYPE ONLY) - ADDRESS my
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
NEAREST
CROSS ST. T,TA�n�c� hC D�+c�/ ,
ABSORPTION UNIT,BTU OWNER I%CRIS, CTEOPM
AIR HANDLING UNIT,CFM MAIL
ADDRESS SAME
BOILER.BTU CITY 1L JILE CITY -.TL+ TEL.NO, 4142-0480
1 COMPRESSOR,BTU_4-Hi]n 7 50 CONTRACTOR iFME HCC
RDCnn'
VENTILATION SYSTEM ADDRESS 2034• H. PEM .
EVAPORATIVE COOLER _ CITY S EL L'L= TEL.NO. 442-048_0
FURNACE: EAU X GRPVITvSTATE CLASS
1 FLOOR BTU _100.,.000— ICENSE
50 LNO, 2 5094 C O
HEATER: SUSPENDED—UNIT— DISTRICTNO. GROUP ' (ONE ACBBSE0 BY
WALL -
INSPECTION RECORD _ 4
O
• V
cc
O
Plan check fee 25% of above.
PERMIT ISSUING FEE; 4 50 Z
TOTAL FEE 5
PLAN CHECK APPLICANT
NAME
ADDRESS '
CITY TEL.NO. -
IHEREBY 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. VENTILATING. AIR
CONDITIONING.
.1 HEREBY CERTIFY THAT I AM NOCTI NG IN VIOLATION OF APPROVALS DATE INSPECTOR'S
CHAPTER 9. DIVISION P, O TH BUS SS SND P OFESSIONAL C ROUGH
OF THE STATE OF CALI OR A /
SIGNATURE • INAL
OF PERMITTEE_
PLAN CHECK VALID ION CK. M.D.' casx PERMIT VALIDATION' M.D. tnsry
WORKERS COMPENSATION
7 3 1 'DEC 10 4 ,1 C
POLICY HOLDER: -
POLICY NUMBER: ��. 6 a �,
76A 394C '
• CE8161flEV.6/761 APPLICATION FOR PERMIT
US
HEATING VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES.:. BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING —
.WRINT OR TYPE ONLY) ' ADDRESS �[
LOCALITY' l� 1
NO. TYPE OF APPLIANCE OR EQUIPMENT- 'FEE \/
NEAREST'
C. CROSS ST. F,,yif
ABSORPTION UNIT,BTU �'.,Q
OWNER •
AIR HANDLING UNIT.CFM MAIL.
ADDRESS n
BOILER:BTU CITY 1' TEL.
COMPRESSO R,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.N
FURNACE: FAU_GRAVITY 'A STATE. 1 LIC.
FLOOR BTU" LICENSE NO. ` CLASS
HEATER: SUSPENDED_UNIT_ APPROVALS DA E LVSPECTOR'S SIGNATURE
WALL
- ROUGH
- FINAL - 0
INECTIOJ)SP
N RECORD V
at
Pion check fee 25% of above.
PERMIT ISSUING FEE j Z
TOTALFEE
PLAN CHECK:APPIICANT
PLAN CHECK VALIDATION .
NAMEi S tk7vh W ^'1 -
'ADDRESS
CITY TEL.NO. W✓�
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. VENTILATING. AIR
corsD17weINc. - PERMIT VALIDATION - §•60II,8A
I HEREBY CERTIFY THAT I.AM NOT ACTING IN VIOLATION OF
CHAPTER 9. ISION'3. OF THE BUSINESS AND PROFESSIONAL CODE .gel* e
OF THE STATE 0 LIFOR 4 1
SIGNATURE
OFPERMITTEE 2 e'- 2.7,00
DISTRICT NQPROCESSED BY Is e e 2.7.00Ci
p� ---' '0a08-79