HomeMy Public PortalAbout10709 LA ROSA DR_Mechanical__ 7BA3k4C
CE-818(REV.6/781
r, APP ATION FOR MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS 7O
(PRINT OR TYPE ONLY)
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT.BTU
OWNER 6
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AIR HANDLING UNIT.CFM AMAIL
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BOILER,BTU CITY77 Le ' TEL.NO. `
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COMPRESSOR,BTU CONTRACTOR
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VENTILATION SYSTEM 7
ADDRESS
EVAPORATIVE COOLER CITY •, `7 ��� TEL.NO. _
I FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU LICENSE NO. 2 V-7 I CLASS J
/ HEATER: SUSPENDED UNIT_
WALL ApvgovALs DATE INSPECTOR SIGNATURE
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ROUGH
FINAL () V-2,- Q
INSPEC ION RECORD V
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Plan check fee 25%of above. 6
PERMIT ISSUING FEE$ W,*// Hrg . Y
TOTAL FEE1/ 71 ✓��G U
PLAN CHECK APPLICANT . PLAN CHECK VALIDATION
OD/Z/QOM
NAME
ADDRESS
CITY TEL.NO. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH15 APPLICATION AND
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL4 Z 2 9 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. - PERMIT VALIDATION - 4 • • e * 4 1 '
I HEREBY CERTIFY THAT AM NOT ACTIN VIOLATION OF ,
OF THECHAPTESTAT 0 CAN ORNF T E BUSINESS AND PR SSIDNAL CODE .290 1 '7,00
SIGNATURE
OF PERMITT e O • 17.003
DISTgICiNO.•' PgOfp85EO,BY `
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