HomeMy Public PortalAbout10528 LIVE OAK AVE_Mechanical__ 76 A3b4 � CE 818 - 9-71" APPLICATION FOR PERMIT�j
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS V�
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
__jCROSS ST. 6,ft
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OFAPPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION UNIT, BTU d�"` CITY e , TEL. NO.,�CC Srq
CONTRACTOR /�
AIR HANDLING UNIT, CFM n
ADDRESS �S ��� VVe
BOILER, BTU CITY TEL. NO W,�I_'5' I �
COMPRESSOR, BTU STATELIC.
LICENSE NO. Q� L10 2— CLASS ID
VENTILATION SYSTEM DISTRICT NO GROUP ]20NE PROCESSED BY
EVAPORATIVE COOLER �� �/ r
FURNACE FAUG VITY l
FLOOR BTU INSPECTION RECORD C.3
HEATER: SUSPENDED UNIT_ O
F-
WALL w
CIL_
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Plan check fee 25-5 of above See reverse.
PERMIT ISSUING FEE 8 3 00
TOTAL FEE v/l
PLAN CHECK APPLICANT
NAME
ADDRESS
CI TY 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 D E PECTOR'S SIGNATURE
LATING, AIR CONDITIONING
ROUGH
I HEREBY CERTIFY THAT I AM NO ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE B S ESS AND PROFESSIONAL FINAL
CODE OF THE STATE O F NIA
SIGNATURE PERMIT VALIDATION CK M 0 CASH
OF PERMITTEE
PLAN CHECK VALIDATI N CK M o CASH
L L�I�O 2 ? 7 N M.4R 3 1 4 1 D 13.00- a
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE