HomeMy Public PortalAbout9967 LA ROSA DR_Mechanical__ _ �,.. • e`7r�rs-,Jam,ee._ Cc�2-c��, !l
.]BA3B<E(CE-9ISA).9/97 APPLICATION FOR PERMIT
NT HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER )
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING i /�
(PRINT OR TYPE ONLY) ADDRESS ,
LOCALITY Lv _
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
a CROSSST. I✓/J L vY L✓I.y. /1. L
/ ABSORPTION UNIT,BTU 73 lu
OWNER \� L (�✓�_7
/ AIR HANDLING UNIT.CFM LL./0 AL d.. `MAIL � J ;7
ADDRESS
BOILER.BTU �� ,,qpp �J' 7 (/
CITY. L• /, \,`TEL_NQ. r ...:!•OJ'
COMPRESSOR.BTU CONTRACTOR
krl►/1BaNnev_2A�� _N_�U��
VENTILATION SYSTEM ADDRESS SI?k-
EVAPORATIVE COOLER CITY p.� -O ` C /ITE1 ! �2
FURNACE: FAU—GRAVITY STATE " Nom" LIC.
FLOOR BTU LICENSE NO. / I CLASS ` O
HEATER: SUSPENDED_UNIT—
DISTRICT NO. GROUP ZONE PROC SSED BY
`WALL (] �,`
44-W 6e-iv1-K t,
'/• INSPECTION RECOR
` fit �� • C C - m
O
Plan check fee 25% of above. t;
W
PERMIT ISSUING FEE — Z
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL .
ORDINANCES AND LAWS REGULATING HEATING. VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTORIS SIGNATURE
CHAPTER 9, DIVISION 3. OF THE BUSINE AND PRO«<ZONAL CODE
OF THE STATE OF CAU ROUGH
SIGNATURE FINAL a S
OF PERMITTE
PLAN CHECK VALIDATION CK. M.C. CASH PER /TA�VALIDATIO [K. M.O. CASH
9 9 ,9-sjn 16 41 0 2 7.0 ®sa