HomeMy Public PortalAbout9026 LONGDEN AVE_Mechanical__ • _1, ` �� ` .
76,A364 - CE818-1/75 ,
` APPLICATION FOR PERMIT
r HEATING - VENTILATING - AIR CONDITIONING
-COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEERADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. [? c� �� Z_
FO'R APPLICANT TO FILL IN OWNER
• (PRINT OR TYPE ONLYP LLQ/
MAIL I 6
TYPE&SIZE OF EQUIPMENT _ IA�DDF2ESS._.
NO SEE BACK OF APPLICATION FEE - .. -
FORCE AIR FURNACE, BTU CITY /��' '47 1 TEL. NO. _I'r13Z
CONTRACTOR,_
COMPRESSOR, BTU X
ADDRESS
VENTILATION FAN
CITY TEL. NO '
LIST ALL OTH S BELOW STATE LIC
LICENSE NO. CLASS
DISTRICT NOGROUP ZONEe PROC ED RY
INSPECTION RECORD
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Plan check fee. See reverse. z
PI"H\II'I' 1551;111'C RI,I,
I OTA 1, FF, '
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
ROUGH
I HE CERTIFY THAT I AM NOT ACTING IN VIOLATION 1
OF CHAPTER 9, DIVISION 3, OF TH BUSINESS�AND PROFESSIONAL FINAL �.(- Zd 8 ' �,-�"
CODE OF THE STATE OF CALIFOR �y,
SIGNATURE Imo' JPERMIT V L•ID IO1V CK M 0 CASH
OF PERMITTED `���c����
PLAN CHECK VALIDATION CK M 0. CASH !/
5 7 -DEC 4 1a 9.0 0 Azz