HomeMy Public PortalAbout10732 LA ROSA DR_Mechanical__ 76 A364- CE BIB -I/]9 �L
aPL!1:C7ATfON FOR PERMt�
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER �OS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST 1
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) MAIL
M/1'1L/_ CLL, O
TYPE&SIZE OF EQUIPMENT ADDRESS ^7/ �j
NO. FEE O / 3 Z- �• � KOS/f
SEE BACK OF APPLICATION
FORCE AIR FURNACE, BTU CITY % G� EL. NO. 2-0/ S
CONTRACTORe ce
COMPRESSOR, BTU
ADDRESS 2 O HGr
VENTILATION FAN CITY nTEL. NO.
LIST ALL OTHERS BELOW STATE LIC. O
,p LICENSE NO. '2 S 3 CLASS G- S
_EL.�1 ���J,ZRS_�1 {� DISTRICT NO, Ge)UP nZONE SSED BY
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ZSD o00 9 SC INSPECTION RECORD
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Plan check fee. See reverse.
PrIOUT ISSI"ISG PGI': S 3 00 '
11'011'AI,
PLAN CHECK APPLICANT
LP / t
ADDRESS:2�30 /
CITY ��� / - TEL.NO.o-'2/'Zp '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCESANO LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATINS, AIR CONDITIONING.
ROUGH f
HEREBY CERTIFY THAT M NOT AC G IN IIOLAT ION 1AZ� i
OF,CHaP iER 9, DIVISION 3. - THE BUSP Es ID PP,FE55IONAL FINAL
CODE OF THE ST E OF FORNIA.
sICNAT URE PERMIT VALIDATION cK. .o. CASH
01 PERMITTEE Zl2✓__
PLAN CHECK VALIDATION CK. M.O. CASH
53 81JUL .21 41 0„ 1 0:5`0 A96