HomeMy Public PortalAbout10410 MILOANN ST_Mechanical__ 76A 4C
CE-616(REV.6/78)
6s APPLICATION FOR PERMIT
HEATING - VENTILATING.- AIR CONDITIONING `
COUNTY OF.LOS.ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS �' LO/�I/V, �f
LOCALITY f
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL ��
ADDRESS
BOILER,BTU '- CIT TEL.NO
COMPRESSOR,BTU CONTRAC R
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER s ,
CITY TEL.Nb.
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FURNACE: FAU GRAVITY STATE CLIC
LA554��� '
FLOOR BTU LICENSE NO..aX
HEATER: SUSPENDED-UNIT • APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH
FINAL
INSPEla.RECORD u
Plan check fee 25%of above. -
PERMIT ISSUING FEE$ us
TOTAL FEE-
PLAN CHECK APPLICANT- PLAN'CHECK VALIDATION"
NAME
ADDRESS (�f L -7 S - l)•L) 8 J
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 26 3 0,8 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION # o o o o'4 1
1 HEREBY CERTIFY THAT 1 AM'NOT ACTING IN VIOLATION OF
CHAPTER 9, DIVI O '37THE BUSINESS.AND PROFESSIONAL CODE 2 00 27.00
OF THE STATE CALIFOR A.
SIGNATURE '
OF PERMITTEE •O O,O Z /',Q O U
DISTRICT NO. PROCESSED BY V 0 O 3 r7('1,
%S / 7