HomeMy Public PortalAbout5456 LOMA AVE_Mechanical__ 76A3�64 - CE818- 3-69 APPLICATION FOR PERMIT %7
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HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS c
BUILDING A•NQ SAFETY DIVISION
JOHN A LAMBIE, COUNTY ENGINEER -LOCALITY �—
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST kev
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) - OWNER
MAIL - i
NO. TYPE OF APPLIANCE OR EQUIPMENT _ FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL 'NO
• - f
AIR HANDLING UNIT-, CFM .CONTRACTOR
BOILER, HORSEPOWER ADDRESS S TA
•
CITY TEL. NO r 3
COMPRESSOR, HORSEPOWER
L CENSE NO d /3 CLASS ` c
VENTILATION SYSTEM , DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE. FAU GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER. SUSPENDED UNIT
WALL
u
'F O
V
Loa
NEW—ADD ITION_ PERMIT S 3 00 Z
ALTER—REPAIR'— TOTAL" FEE S
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
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,VENTI-
LATING, AIR CONDITIONING. APPROVALS ATE INS TOR'S S A RE
I HEREBY CERTIFY THAT I AM NOT ACTING IN V ATIO OF ROUGH __
CHAPTER g, DIVISION 3, OF TH BUSINESS A OFE ONAL FINAL '
CODE OF THE STATE OF CA IA. - -
SIGNATURE JACK R. ALLEN, SUPERVISING MECHA ALE G' .
OF PERMITTEE
PERMIT VALIDATION CK. CASH
PLAN CHEC LIDATION
LAC0 4 3 4 t9,N FEB 9 4 1 D 5.0'0~ Q
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -