HomeMy Public PortalAbout9458 LA ROSA DR_Mechanical__ ',6A364 ' CEB,s'= 3-69 APPLICATION FOR PER IT
HEATING - VENTILATING - AIR CONDITIONING '
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS" `l
BUILDING AND SAFETY DIVISION L
JOHN A LAMBIE, COUNTY ENGINEER LOCALITY
(�OLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS
FOR APPLICANT TO FILL IN OWN
(PRINT OR TYPE ONLY)
MAI
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADORES
ABSORPTION SYSTEM, BTU CITY EL. N0.
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS
CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE - /
LICENSE NO Q CLASS (� _4
VENTILATION SYSTEM DISTRICT N0. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER /r
FURNACE: FAU GRAVITY (6 l
FLOOR BTU IN PEC ION RECORD
HEATER: SUSPENDED UNIT
WALL )
CL.
O
' V
0
F
V
w
a
NEW-ADDITION- PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $ lo,
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 ORDINANCES AND LAWS REGULATING HEATING,VENTI- APPROVALS - DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3 OF THE BUSINESS AN PROF NAL FINAL •
CODE E THE STATE OF A IA.
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
Af
0 -95 5 N JUN 1. 8 4 1 D 10.50-
SEE
0.5ONSEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76'" 9-11- CE 618 - 9-71 APPLICATION F PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING Ay/s'Q
DEPARTMENT OF COUNTY ENGINEER ADDRESS / o
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. �,ef
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) d b
No. TYPE-OFAPPLIANCE OR EQUIPMENT FEE
ADDRESS / �� 1/� iP0 D/Iy•
CITY j� C� TEL. NO.
ABSORPTION UNIT, BTU
CONTRAC OR — GG
AIR HANDLING UNIT, CFM
ADDRESS. �j ;F/- /I✓/�
BOILER, BTU
CITY �f/ �� TEL. NO.
ICOMPRESSOR, BTU �C O STATE' LIC.
LICENSE NO. CLASS G��v
VENTILATION SYSTEM DISTRICT N�OJ GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER _(,7 �
l CD
FURNACE: FAU GRAVITY vNSPECT]ON"RECORD C-1FLOOR BTU 14-tr; -'_`� � t) -
HEATER: SUSPENDED UNIT_ MM �(
WALL
d
� tt Cn
• Z
Plan check fee 2-5% of above. See reverse.
PERMIT ISSUING FEE 8 s 00
rOTAL FEE J
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO.
I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- LROUGH
LS DATE INSPECTOR'S SIGNATURE
LATING, AlR CONDITIONING
HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISIO 3, OF THE BUSINES ND PROFESSIONAL - —�
CODE OF THE STATE OF ALIFORNIA. 1
SIGNATURE PERMIT VALIDATION CK. M 0/' 'CASH
OF PERMITTEE
PLAN CHEC - VAATION CK. M.0. CASH .
LA
7�7 AUG 28'4 1 .D 1 3.0,0-
.
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE �`�