HomeMy Public PortalAbout10726 MILOANN ST_Mechanical__ ,76 A364 -CE 818 - 9-71 APP•L ATIONFOPERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FNEAREST
07 �a �/� 1
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION '
_ /(� S/Ivy D/c/
FOR APPLICANT TO FILL IN "' "' C c�
(PRINT OR TYPE ONLY) O N 07Az A
'
MAIL ,s
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS r
ABSORPTION UNIT, BTU CITY TEL. NO.
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ONEU
OC ED BY]
EVAPORATIVE COOLER fJ 1
FURNACE: FAU_GRAVITY v
FLOOR BTU INSPECTION RECORD v
HEATER: SUSPENDED UNIT_ O
F-
WALL tv
a-
371
Plan check fee 25% of above. See reverse.
--PERMIT ISSUING FEE S 3 Oo
TOTAL FEE od
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
LND REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
LL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
AIR CONDITIONING.
ROUGH
EREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION
PTER 9, DIVISION 3OF HE BUSINESS AND PRO ESSIONAL FINAL �,� f/�j�y��F THE STATE OF ALI IA.TURE PERMIT VALIDATIONRMITTEE CK. M.O. CASH "
PLAN CHECK vAUMATION CK. M.O. CASH (
I_Ap, '3 .1 6 5%3 SEP 13 4 1 D 8-00A
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE