HomeMy Public PortalAbout10152 NADINE ST_Mechanical__ 46 A364 - CE 618 - 9 71 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY TEL NO
ABSORPTION UNIT BTU
CONTRACT
AIR HANDLING UNIT CFM
ADORES�m� 9
/ BOILER BTU
D CITY c TEL NO
COMPRESSOR BTU ATELIC
STATE
LICENSE NO 6� �7 CLASS C �O
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER 0 : — cam.
FURNACE FAU GR Y� C
FLOOR—BTU. G INSPECTION RECORD
HEATER SUSPENDED UNIT_
WALL
W
CL
N
Z
Plan check fee 25% of above See reverse
PERMIT ISSUING FFF S 3 00
TOTAL FEE 3 OC
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI APPROVALS D E 1 PECTOR 9 SIGNATURE
LATING AIR CONDITIONING
I HEREBY CERTIFY THAT I AM NOT ACTINO IN VIOLATION ROUGH
OF CHAPTER 9 DIVISION 3 OF HE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF CALIF PNIA
SIGNATURE PERMIT VALIDATI CK M 0 CASH
OF PERMITTE
PLAN CHECK VALIDATION CK M 0 CASH
U& 7"— APa 6 4 1 D 1 3 0 0, wm
SEE BACK OF APPLICATION FOR CPM LETE FEE SCHEDULE