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76A364C
CE-818(REV.11/78)
®� APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING U L7 p
(PRINT OR TYPE ONLY) ADDRESS '
LOCALITIf�� MP
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE Le G
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNEROr— Ll U U
tr—
AIR HANDLING UNIT,CFM MAik I /
ADDRESS _ V/ O 4
BOILER,BTU CITY TEL.N0.
COMPRESSOR,BTU CONTRACTOR v
VENTILATION SYSTEM
ADDRESS , 'z�-
EVAPORATIVE COOLER CITY OV I TEL.N6
FURNACE: FAU GRAVITY STATE LIC.
FLOOR BTU LICENSE N � CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
IROUGH
`I FINAL �'L$� j f/�--�� 0
C� U2c, ab INSPECTION RECORD Im
Plan check fee 25% of above.
PERMIT ISSUING FEE$ z
TOTAL FEE, p
PLAN CHECK APPLICANT
P&I&X31419CK VALIDATION
NAME 2 9 d . C
ADDRESS C p '-7 -733 0
CITY TEL.NO.
I HEREBY ACKNOWLDGE THAT I HAVE READSTATE THAT THE ABOVE ES CORRECT AND AGR ETHIS TO COMP)YATION WIITH ALL :9 6 6 a 4 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION $� o o 0 0 4 1
I HEREBY CERTIFYQNIA
T ACTING N VIOLATION `OF
CHAPTER 9, DIVISION-3, N S AND P FESSIONAL CODE 2 0 o27,00
OF THE STATE OF CALIFO
SIGNATURE '
OFPERMITTEE o 0 o 2 7,O O Cl
DISTRICT NO. P CESSED O 9. 1 3-79
7 75A364-CEB18-1/70 APPLICATION FOR PERMI
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FNEARES7T
DEPARTMENT OF COUNTY ENGINEER
47
BUILDING AND SAFETY DIVISION r
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
FOR APPLICANT TO' FILL IN OWNER i
(PRINT OR TYPE ONLY) MAIL
NO. TYPE OF APPLIANCE-OR EQUIPMENT FEE ADDRESS
CITY TEL:-NO.
ABSORPTION SYSTEM., BTU
CONTRACTOR ,ria
AIR HANDLING UNIT, CFM
ADDRESS S^
BOILER, HORSEPOWER CITY TE O.J^ 0�3�
COMPRESSOR, HORSEPOWER STATE / LIC.
LICENSE NO. O S3 CLASS
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE PRyyO��CESSED BY
,gyp
EVAPORATIVE C006U
FURNACE: FAU VITY INSPECTION RECORD
FLOOR BTU
HEATER: SUSPENDED UNIT_
WALL
C
• C
F
Li
P $
NEW—ADDITION— ERMIT• 3 00 G
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 ABOVE IS CORRECT AND AGREE TO COMPLY, -
WITH ALL ORDINANCES' AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
ROUGH
I HEREBY CERTIF H I AM NOT ACTINO VIOLATION
OF CHAPTER 9, DIVIS 3 OF. E BUSIN S ROFESSIONAI FINAL
CODE OF THE STATE F IF O NIA. l
SIGNATURE . ' JACK R. ALLEN,SUPERVIUQjEANICAL ENG'R.
OF PERMITPERMIT VALIDATION M.O. CASH
PLAN CHECK VALIDATION
1 1 3 7 O'er IUL•1.2 4 1 D 13.00
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE '