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76 A364`= CE 818- 6_73 ��--
APPLIC'AON FOR P MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES 7NEAREST
DEPARTMENT OF COUNTY ENGINEERBUILDING AND SAFETY DIVISION M�� J
FOR APPLICANT TO FILL IN OWNER
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MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS /(x
CITY TEL. NO.
ABSORPTION UNIT, BTU
AIR HANDLING UNIT, CFM CONTRACTOR
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BOILER, BTU CITY �� y TEL. NO.J j? �-
COMPRESSOR, BTU -3 lfr �^ e) _
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PER\IIT ISSUING FEE S 3 00
TOTAL FEE � r
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 ORDINANCESAND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
I HEREBY CE I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, �VE�'S'
THE BUST SS AND OFESSIONAL FINALAw
CODE OF TME NIA.
SIGNATURE -PERMIT VALIDATION CK. M.0. CASH
OF PERMITTE
PLAN CHECK VALIDATION CN. V.0. CASH
7 rE$ 44' 4 1 U 1 5.5 u'-
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76 A364- CE 818- 5-73
APPLI TION FORC PE MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE y LIC.
LICENSE NO.c2 D CLASS C� 2 V
VENTILATION SYSTEM DISTRICT N0. GROUP zoNE ssED BY
EVAPORATIVE COOLER "Jf� �— C�Z
FURNACE: FAU GRA IT C�
FLOOR BTU7 L5 INSPECTION RECORD
HEATER: SUSPENDED UNIT_
WALL
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CD
F—
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W
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Plan check fee 25% of above. See reverse.
PERMIT ISSGING FEE 8 3 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THISJE
AND STATE THAT THE ABOVE IS CORRECT AND AGRE
WITH ALL ORDINANCES AND LAWS REGULATING HEAAPPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH IHEREBY CERTIFY A M NOT ACTI G OF CHAPTER 9, DIVISIF E BU D PFINAL
CODE OF THE STATE ALIF IA.
SIGNATURE PERMIT VALIDATION K. M.O. CASH
OF PERMITTE
PLAN CHECK VALIDATION CK. M.0. CASH
7 6 89-4-SEP 441 0 1 5.5 0 •to
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
BAB64-CEB;�_B-BB - APPLICATION FOR PERMIT 1`4W /e- �' Y
HEATING - !VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDIN
JOHN A. LAMBIE. COUNTY ENGINEER :ADDRES �iiJ1P/O�
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY �p �,s G�
V. NEAREST v s
FOR APPLICANT TO FILL IN CROSS ST.
(Print or type only) OWNER
NO.. TYPEJOFAPPLIANCE OR EQUIPMENT FEE ��� ti c
MAI L
ADDRESS
ABSORPTION SYSTEM, BTU—, CITY TEL. NO.
AIR HANDLING UNIT, CFM CONTRACTOR -1-�C.2M
BOILER, HORSEPOWER ADDRESSg, I
COMPRESSOR, HORSEPOWER CITY ®AJ*fC11Ar; TEL. NO..,& • ?`
VENTILATION SYSTEM LICENSE=NO. pa tY CLASS C- ✓'17
DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER0r/ C �Q
FURNACE: FAU GRAVITY
FLOOR-BTU INSPECTION RECORD
HEATER%SUSPENDED UNIT "
WALL
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NEW—ADDITION— PERMFT.. $ 3 00 r
ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
City Tel. No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ISkUSNESS
AGREE TO COMPLY
WITH ALL ORDINANCE AND A HEATING, VENTI- APPROVALS DATE 1 CTOR'S IGNATURE
LATING,AIR CONDITIO ING. ROUGH
I HEREBY CERTIF T NG IN VIOLATION :FINAL
OF CHAPTER 9, DIVI51 3. OF ND PROFESSIONALCGDE GF THE STAT CALIFORJACK R. ALLEN,SUPERVIiI�IG-MECHANICAL ENG'R.
SIGNATUREd� -PERMIT VALIDATI0t1. S.i�� M.O. CASH
OF PERMIT
T
PLAN C CK V DATION
.9 4 4 9 ni'ti 18 4 ? D 18..00-
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1 E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE /