HomeMy Public PortalAbout6002 LOMA AVE_Mechanical__ 76 A364 �F_E 818-1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONOITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS Ni _net. (5?c-,e-
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IAN . OWNER RR /��i
(PRINT OR TYPE ONLY) /V/'� Va eQ cl
MAIL
NO TYPE&SIZE OF EQUIPMENT FSE T
ADDRESS ��}
SEE BACK OF APPLICATION J (�
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FORCE AIR FURNACE, BTI/o
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CONTRACTOR
COMPRESSOR, BTU
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VENTILATION FAN
CITY TEL. NO.
LIST ALL OTHERS BELOW STATE LIC.
LICENSE NO. CLASS
DISTRICT NO. GROUP ZONE PRO�SED BY
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INSPECTION RECO
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Plan check fee. See reverse.
F1-',W%11T ISWI\G FI-J: c
LT Ir 1, FE1-:
PLAN CHECK APPLICANT
NAME
ADDRESS 450C)_g
CITY �� - TEL.NO PJ-a�Ia
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.
ROUGH ✓,'„ - - � __
I HEREBY CERTIFY THAT 1 AM NOT ACTING IN VI CATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PRO SIGNAL l.�rr
FINAL
CODE OF THE STATE OF CALIFORNIAOt �' ..
SIGNATURE -. PERMIT VALIDATION CK. M.O. CASH
OF PERMITTE
PLAN CHECK VALIDATION CK. M.G. CASH
6 0 6 Hatt 29 4 U 2 3 2 5 ��U