HomeMy Public PortalAbout5602-5604-5606 MCCULLOCH AVE_Mechanical__ 76 A364- CE 818-1/75
APP CATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES BUILDING ikz
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL r
N0. TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION
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CITY TEL. NO.
FORCE AIR FURNACE, BTU I�BO o� i
��jj CONTRA OR
COMPRESSOR, BTU 441DCl
ADDRESS
VENTILATION FAN CITY C40 TEL.
LIST ALL OTHERS BELOW STATE LIC, qq
FLIIEN,SE NO. CLASS C�
ICT N0. GROUP ZONE PROCESSED BY
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INSPECTION RECORD
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Plan check fee. See reverse. z
PERMIT I551:nc FEF: S 3 00
OTrAI. FEE 92 a
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I VE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS p ECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND S GULATING TING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATINS.AIR CONDITIONING.
I HEREBY CERTIFY HAT A NOT A IN IN VIOLATION ROUGH
OF CHAPTER 9, DIVISIO 3, 0 TH BUSI�S A PROFESSIONALJ.FINAL
CODE OF THE STATE 0 CAL ORNI
SIGNATURE ••' PER IT VALIDATION CK. 0. CASH
OF PERMITTEE
PLAN CHEC ALIDATION CK. 0. CASH ;
22-71-JUL 341 U 3 3.0 C?.09$