HomeMy Public PortalAbout9451 LA ROSA DR_Mechanical__ 76 A364 - CG 818 - 9-71 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES - BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST � 0�C�L_
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS 1
CITI�� ,.� TEL. NO. �
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
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ADDRESS
BOILER, BTU
CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP Q ZONE
��D BY
EVAPORATIVE COOLER ��� '`� 1OA
FURNACE: FAU_GRAVITYo
INSPECTION AMbIRID
FLOOR BTU
HEATER: SUSPENDED UNIT_ D F-
WALL v
w
10, CL.
co
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S s 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
LING
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ORDINANCES AN AWS REGULATING HEATI VENT(- APPROVALS DATE INSPECTOR'S SIGNATURE
IR CO NDITI ONIN . ROUGHEBY CERTIF THA I AOT A TIN IN TION
R 9, DIVISI N " F TH USIN AN PR IONAL FINAL ?�HE STATE CA IFORREPERMIT VALIDATION CK. M.O. CASH
ITTEE
PLAN CHECK VA (DATION CK. M.0 CASH
f ^r. 3- 6 5 373. GOT 1. 7 4 1 D 8.Q O A
SEE BACK OF APPLICATION FOR COM PLETE FEE SCHEDULE