HomeMy Public PortalAbout9962 LA ROSA DR_Mechanical__ 76A364-.CE816 -1/70 •�" •C--) " `
PPLICATION FOR PERMIT [�
HEATINd-VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES . BUILDING
DEPARTMENT OF COUNTY ENGINEER - ADDRESS Q
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY, ENGINEER NEAREST
COLEMAN W. JENKINS,_SUPERINTENDENT OF BUILDING CROSSST.
FOR APPLICANT TO FILL IN OWNER—'--
WNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
TEL. NO.
ABSORPTION SYSTEM, BTU _
CONTRA O
AIR HANDLING UNIT, CFM
A,DDRES
BOILER, HORSEPOWER
CaPTEL. NO. ^7
COMPRESSOR, HORSEPOWER '� STAT LI .
LICENSE' CLA s5-
VENTILATION SYSTEM DISTRICT)NO. CLASS I GROUP ZONE PROCESSED T ,
EVAPORATIVE COOLER
FURNACE:, FAU VITY /� INSPECTION RECORD
FLOOR BTU (J �/ _
HEATER: SUSPENDED_UNIT _ �_ ' 0��; r-6 G
WALL
a
U
C
H
LL
n
17
v.
NEW _ADDITION— PERMIT S 3 00 - Z
ALTER_REPAIR" TOTAL FEE.. S Af
..
PLAN CHECK APPLICANT
NAME-
ADDRESS
'CITY - TEL.NO.
1 HEREBY ACKNOWLEDGE THAT I HAVE'READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALLOPOINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS 6 TE . ECTOR' IGNATURE
LALING, AIR CONDITIONING.
RO GH
1 HEREBY CERTTHAT 1 NOT ACT ING'IN VIOLATION _
OF CHAPTER 5. DIV'SSIG
N 3 F HEE BUSINESS AND PROFESSIONAL FINAL
OF
CODE OF THE STAT F F NIA.
SIGNATURE JACK R. ALLEN,SUPERVISING MECHANICAL ENG-R.
OF PERMITT
PERMIT VALIDATION CASH
PLAN CHECK VALIDATION
ar_ 0 6 5 .2'z' JUN 3 4 1 D
SEE BACK OF APPLICA71ON FOR COMPLETE FEE SCHEDULE