HomeMy Public PortalAbout10674 LORA ST_Mechanical__ 76 A364 - CE'918 - 9-71 p
PPUCATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDINGr
DEPARTMENT OF COUNTY ENGINEER ADDRESS A65'd 06�WjOP 67-h
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.�G �
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL 3 "
NO. TYPE OFAPPLIANCE OR EQUIPMENT FEE ADDRESS
CITY Ale .► EL. N
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM ���
ADDRESS,
BOILER, BTU CIT ' T L. N ..��
COMPRESSOR,. BTU STATELIC.
LICENSE NO 1 Z CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE I PROCESSED BY
EVAPORATIVE COOLER S-144 , A-/ o}
FURNACE: FAU_GRAVITY , INSPECTION RECORD v
FLOOR BTU
HEATER: SUSPE D N
WALL C �6� v
W
/ 7 r clu. z
/ I —
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 a 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO. a
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE SPECTO 'S SIGNATURE
LATING, AIR CONDITIONING.
' ROUGH
I HEREBY CERTIFY THAT I AM NOT AC N6 IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF TH NOT AND PROFESSIONAL FINAL D
CODE OF THE STATE OFC OR
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH )
I
crr nww nr weep i�ermu rno�nnw o�rrr rrc r�urrnn r