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SASZA CE-81'�Y=•8-88 APPLICATION FOR PERMIT � -7
HEATING —VENTILATING - AIR CONOITIONI G
Y•
J COUNTY OF LOS ANGELES ��/r. (o
DEPA• TMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALIT °
FOR APPLICT TO FILL IN CROSSS ST
AN.
(Print or type only)
OWNER
ND.. TYPEJOFAPPLIANCE OR EQUIPMENT FEE
MAIL
n ADDRESS
ABSORPTION SYSTEM, BTU D v CITY TEL. NO."
6 b1
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS ✓t^
COMPRESSOR, HORSEPOWER-' CITY EL. NO 3
STATE LI C.
VENTILATION SYSTEM L'ICENSIfNO. CLASS ZD
DISTRICT NO GRO ZONE PROCESSED BY ,
EVAPORATIVE COOLER � �� •
FURNACE: FAU GRAVITY� LJ r t7
FLOOR-BTU INSPE TI ON RE
j,ORD
HEATER:.SUSPENDED UNIT '
WALL
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NEW_ADDITION PERMIT. $ 3 00
ALTER REPAIR TOTAL FEE
Plan check pplicant—
Name a
Address y�
City el. No =2
I HEREBY ACKNOWLEDGE THAT 1 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 I ECTOR'S SIGNATURE .
LATING,AIR CONDITIONING. ,
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION .FINAL
:124 X4 oz
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE OF CALIFORNIA. JACK R. ALLEN,SUPERVISI ECHANICAL ENG'R.
.- SIGNATURE '
PERMIT cI<. m.o. CASH
VALIDATION
OF PERMITTEE
PLAN CHECK VALIDA'T'ION
2 4 6� AI's g 4 L D
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
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