HomeMy Public PortalAbout5340 MCCULLOCH AVE_Mechanical__ 76A364E ICE-B,BAI-8/77 APPLICATION FOR PERMIT
<' HEATING - VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
ADDRESS 54
(PRINT OR TYPE ONLY) ®C
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LOCALITY L f r •
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER,BTU CITY r �;a/ EL.NO. ?(� �
COMPRESSOR,BTU CONTRACTOR V
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU I GRAVITY STATE LIC.
FLOOR BTU x/(20 LICENSE NO. CLASS
HEATER: SUSPENDED UNIT- DISTRICT NO. GROUP ZONEROC SSED BY
WALL
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INSPECTION RECORD 0
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V
of `
O
Plan check fee 25% of above.
PERMIT ISSUING FEE$ Z
TOTAL FEE
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, VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGQfURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS ANIVPROFESSIONAL CODE ROUGH
OF THE STATE OF CA ORNIA.
SIGNATUREFINAL
OFPERMITTEE
PLAN CHECK VALIDATION CK. M.O. ' CASH PERMIT VALIDATION cK M.O. CASH
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3 4 9r--AUG 17 4-1 U 2 °7.0 0
P01.101 HOLDER
POLICY NUMBER: 673.o-lyL (� � es