HomeMy Public PortalAbout9561 LA ROSA DR_Mechanical__ 76A364E ICE-8I BA)-9/77 Y�
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APPLICATION FOR PERMIT
HEATIAIG APPLICATION
- AIrI�• COOVDITIONIR_1G
COU OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
'BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS i
• LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE A
NEAREST-----'I
CROSS ST
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL ,
7"1-0 ADDRESS
BOILER,BTU "`� CITY Q TEL NO
COMPRESSOR,BTU CONTRACTOR Cy
VENTILATION SYSTEM ADDRESS '
EVAPORATIVE COOLER CITY TEL NO
FURNACE FAU_GRAVITY STATE LIC
FLOOR BTU LICENSE NO CLASS ,
HEATER SUSPENDED - UNIT— DISTRICT No ROUP ZONE P ESSED BY
WALL _ti - �'".'� �• - - - - - - -
IN P CTION RECORD O
�o� 1U 3' /8• !C l�2 fCO�nrcp�d' I
O
Plan check fee 25% of above Pe tibd
Pasr -J4
PERMIT ISSUING FEE$ ko aku a 6 - 2,0 .-79
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS'
CITY, TEL NO ,
t
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 ,
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9 DIVISION 3, THE BUSIN SS AND PROF SIGNAL CODE +
OF THE STATE OFC ` IA ROUGH (�
SIGNATURE FINAL
OFPERMITTE •vv
PLAN CHECK VALIDATION CK Mo CASH PERMIT VALIDATION cK' n10 CASH
6 7 7110 APR, `.3 4.1, 0 2 7.0 0 ®�o
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