HomeMy Public PortalAbout9928 NADINE ST_Mechanical__ .,76 AQ"49- CE 818- 5-73
APPLICATION FOR PERMIT
HEATING- VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING A
DEPARTMENT OF COUNTY ENGINEER ADDRESS T•
BUILDING AND SAFETY DIVISION LOCALITY . E,� 6 4f,',7-y
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER AA
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU ` CITY �-� TEL. NO.
COMPRESSOR, BTU Z STATE 7�
LIC.
Z
LICENSE NO. 9 Z � CLASS
VENTILATION SYSTEM -DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER
/ FURNACE: FAU_GRAVITY INSPECTION RECORD
FLOOR BTU
HEATER: SUSPENDED-UNIT-
WALL
USPENDED UNIT_WALL
a
O
U
O
U
• W
d
C/7
Plan check fee 25% of above. See reverse.
Z
PERMIT ISSUING FEE $ 3 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CI TY 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. - Q
I HEREBY CERTIFY THAT I AM NOT ACTINO IN VIO ROUGH ATION
OF CHAPTER 9, DIVISION 3 OF TUL.34PINESS AND PROFE ZONAL FINAL ell
CODE OF THE STATE RMA.
SIGNATURE PERMIT VALIDATION K. egKl. sH .
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.0. CASH
185CA'MAt2841 a 15.50 A
SEE RACK OF APPI I!'ATIOY FOR MSI PI CTC FFc arUVn1Jf r.
76A364-C.E818�_68.` APPLICATION FOR PERMIT.
~ HEATING - VENTILATING - AIR CONDITIONING
COUNTY bF LOS ANGELES
DEPARTMENT OF`COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 7'
INEAREST
FOR APPLICANT TO FILL IN CROSS ST. e 2
(Print or type only) 1,L,51
NO., TYPEJOFAPPLIANCE OREQUIPMENT FEE OWNER V/
MAIL
ADDRESS C712, �ff /�fJG'
ABSORPTION SYSTEM, BTU CITY - ' E C T TEL. NO�T�({S6z
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS
COMPRESSOR, HORSEPOWER CITY TEL. NO.
STATE LI C.
VENTILATION SYSTEM LICENSE NO. CLASS
DISTRICT NO GROUP ZONE �CESSEY
EVAPORATIVE COOLER5/O� �
FURNACE: FAU I M
FLOOR_BTU �J INSPECTION RECORD
HEATER:.SUSPENDED—UNIT-
WALL
USPENDED UNITWALL
r
o_
0
0
F-
c.J
w
a
C/)
� z
NEW—ADDITION— PERMIT S• ' 3 00
ALTER—REPAIR— TOTAL FEE $
Plan check applicant
Name
Address
Cit Tel.
1 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... CjATEj 1 ECTOR'S SIG TORE
LATING, AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION y
ROUGH 1 31L,V
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATLIFO IA.
JACK R. ALLEN,SUPERVISING MECHANICAL ENG'
OIF GNATPERMRITTEE -PERMIT VALIDATION CK. M.O. ASH'
PLAN CHEek VALIDATION ell
Vi t' 8,4 0.5' .-FEB 14 41 0 '7 4
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE