HomeMy Public PortalAbout5730 NOEL DR_Mechanical__ 7GA364C
CE 616(REV 6/76)
as APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING ,D q
%'
(PRINT OR TYPE ONLY) ADDRESS /
LOCALIT /gym `
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST 1 V
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL //��
ADDRESS CJ
BOILER BTU T)/`n CITY TEL NO
/ COMPRESSOR BTU rte+' �� CONTRACTORoe
� 1`+
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CIT TEL NO �
FURNACE FAU I GJ� STATE LIC
FLOOR BTU 301, /0
ID LICENSE NO,07 CLASS O
HEATER SUSPENDED UNIT_ APPROVALS DATE INSPECTOR S SIGNATURE
WALL
ROUGH
FINAL
0
INSPECTION RECORD V
O
Plan check fee 25%O of above 96
PERMIT ISSUING FEE$ 00
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME `
ADDRESS
Y
CIT _AEMddi�fTEL NOS/�'!O
1HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND -.009870A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR # 6 a 6 6 4 ,
CONDITIONING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF 2 — 2700
CHAPTER 9 DIVISION 3 OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CAUEORNIA
SIGNATURE 6 6 6 270005
OF PERMITTEE
04. 14-8o
DISTRICT NO PROCESSED Y
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