HomeMy Public PortalAbout6274 LOMA AVE_Mechanical__ 76A364,- CE818 - 3-69 APPLICATION FOR PERMIT �.
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HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES F' SG
DEPARTMENT OF COUNTY ENGINEER 7 Q
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER Y
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDINGTT. e
FOR APPLICANT TO FILL IN OWNER '
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS ' L
ABSORPTION SYSTEM, BTU CITY TEL. NO. - 75(j
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS
BOILER, HORSEPOWER
CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE SSED BY
EVAPORATIVE COOLER __T 7-
FURNACE: FAU GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT
J WALL
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NEW—ADDITION— PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
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 INS TOR'S IGNATURE
LATINIS AIR CONDITIONING.
IHEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION OF ROUGH49
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL t
CODE OF THE STATE OF CALIFORNIA.
SIGNATURE !�.�� `� JACK R. ALLEN, SUPERVI ECHANICAL ENG'R.
OF PERMITTEE (fin `�1 I l'1 1'Y �D
PERMIT .VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
3 0 AUL f 8 4 1 D�/��
-E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE