HomeMy Public PortalAbout9201 LAS TUNAS DR_Mechanical__ 76 :364 -'CE E18 - 9-71 APPLICATION FOR RM T
HEATING - VENTILATING - Al CO 017 IONI G
COUNTY OF LOS ANGELES BUILDING �� h
DEPARTMENT OF COUNTY ENGINEER ADDRESS IJ
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER �A
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRES
CITYLibUSQ TEL. NO.
ABSORPTION UNIT, BTU /I f
CONTRACTORC.
AIR HANDLING UNIT, CFM
ADDRESS/ S (.dA
BOILER, BTU CITY �/JF TEL. NO i6z3
/ COMPRESSOR, BTU-.;, STATE LIC
LICENSE NO. /.),�D CLA.0'3
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE- FAU_GRAVITY C:)FLOOR BTU INSPECTION RECORD v
4
HEATER. SUSPENDED UNIT_
WALLf 117
14 A4 ^ W
0
N
Z
� / C
Plan check fee 25% of above. See reverse.
PEWMIT ISSUING FEE S 3 00
TOTAL FEE v —6
PLAN CHECK APPLICANT ;
N A M E ON Il S 1,V C
ADDRR�E'11SnnS,/� ,Z/ 2�d9Dtt)J9
C I T)6"47 j),G1V,4 TEL N 03j�,I-$10 1, /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION j�j�/a /' ,- !Z-
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCESAND LAWS REGULATING HEATING, VENTI- APPROVA#f DATE S C70R'S SIGNATURE
LATING, AIR CONDITIONING
ROUGH
I HEREBY CERTI T T I AM NO TING IN VIOLATION
OF CHAPTER 9' DIV, IO OF THE BU N S AND PRO SSIONAL FINAL
CODE OF THE STATE C OR NIA �.
SIGNATURE G
OF PERMITTEE PERMIT VALIDATI CK M CASH
PLAN CHECK VALIDATION CK M O CASH
7 4 ? 3 N AUG 11 4 1. D 8.0 ON
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE