HomeMy Public PortalAbout10040 LIVE OAK AVE_Mechanical__ 76 A364 --tE 818 - 9-71 APPLICATION FOR PERMIT
i
ATING - NEN-TILATING - AIR.CONDITIONING
COUNTY OF LOS ANGELES BUILD NSG
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS S.T.
FOR APPLICANT TO FILL IN OWNER \
(PRINT OR TYPE ONLY)
MAIL Q
No TYPE OFAPPLIANCE OR EQUIPMENT FEE ADDRESS V
TEL.NO.� L\
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU
CITY � �(� TEL. NO
COMPRESSOR, BTU 11 dO STATE LIC
LICENSE NO. CLASC^ '1
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER '7 47 �i" �
FURNACE- FAU�GRAVITY ✓` O
\ FLOOR BTU tS0 U eINSPECTION RECORD c.1
01
HEATER: SUSPENDED UNIT_ CD
I--
WALL C_.'j
w
Z
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S 3 00
TOTAL FEE 3
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY 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, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING _
I HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION ROUGH
�./
OF CHAPTER 9, DIVISION 3, OF THE BUSINESPIJAND PR FESSIONAL FINAL / �'�
CODE OF THE STAT OF LIFORNIA
SIGNATUREPERMIT VALIDATION K M 0 CASH
OF PERMITTEE ,
PLAN CHECK VAL A ON CK M O CASH
6 s"�� G_.2? 41 ®.
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE