HomeMy Public PortalAbout9124 LAS TUNAS DR_Mechanical__ 75A364E(CE.81 FAA) 9/77 APPLICATION FOR PERMIT
HEATING = YE OUTING - BIR N®IVI®�III�Q�,
COUNTY O OS ANGELES
DEPARTMENT OF-COUNTY ENGINEER R
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY '
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
• CROSS ST. -
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL -
- ADDRESSee
BOILER,BTU -
CITY - ;TEL.NO.
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO,�Z! .,?_37�
i. FURNACE.: FAU_GRAVITY ' STATE- _ - LIC.
�i FLOOR BTU LICENSE NO. CLASS. Z-4
HEATER: SUSPENDED UNIT- DISTRICT NO. GROUP ZONE . OCESSEDBY
WALL r.
INSPECTION RECORD -
U
Plan check fee 2P/. of above.
PERMIT ISSUING FEE$ Z
TOTAL FEE
PLAN CHECK APPLICANT
NAME - . .
ADDRESS '
CITY TEL.NO.
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 [.NSP OR'S SIGNATURE
CHAPTER 9, DIVISION 3, THE.BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CALI IA., ROUGH
SIGNATURE FINAL - -�
OF PE RMITTE
PLAN CHECK VALIDATION CK M.0. CASH PERMIT VALIDATION CASH
CK. M.O.
.WORKERS COMPENSATION
2 712 N PtiY 4 4.41,1) .4 7.0 0
POLICYHOLDER:
_ .-
/37 0s
POLICY NUMBER: w �v �` . , ...7..:j