HomeMy Public PortalAbout5011 MCCLINTOCK AVE_Mechanical__ 76Aio4 _CE618 - 3-69` APPLICATION, FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING L6
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) OWNER
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY , EL. NO.
CONTRACT R
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, HORSEPOWER
CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY ••w+ �+ I
FLOOR BTU INSPECTION RECORD
HEATER: SUSPEN UNIT
WALL
0
C
c
- o
C
u
ov
u
NEW-/Z/ADDITION— PERMI T $ 3 00 u
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
IHEREBY 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-
TIONING. - APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AlR CONDImay, cam,,
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH &.i V--JI `.Jr 7
CHAPTER 9, DIVISION 3, OF THE B SIR SS AND PROFESSIONAL FINAL
CODE OF THE STATE F CALIFORNIAN
SIGNATURE /' JACK R. ALLEN, SUPER G MECHANICAL ENG'R.
OF PERMITT/ PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
1 2 8 1 JUL '7 4 1 D ,Q o N
rill
=E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE