HomeMy Public PortalAbout10414 OLIVE ST_Mechanical__ 76 A364-"CE 818-1/75
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR- CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS r
BUILDING AND SAFETY DIVISION LOCALITY r
N EAR EST /I
CROSS ST.
FOR APPLICANT TO FILL IN OWNER f r
(PRINT OR TYPE ONLY) f
ar
MAIL
NO. TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION
CITY T NO.
FORCE AIR FURNACE, BTU
CONTRACTOR
COMPRESSOR, BTU
ADDRESS -91
VENTILATION FAN CITY TEL. 22
NO.
LIST ALL OTHERS BELOW STA LIC.
LICENSE NO. CLASS
DISTRICT N0. GROUP ZONE OCESS ED B.Y
INSPECTION RECOR
r
(L
O
U
K
O
• U
W
< Q.
Plan check fee. See reverse.
PE1011T ISSFINC FEE S 4s
TOTAI,-FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT IHAVE 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.
ROUGH •77
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL / 7 ���}�f^~'-•
CODE OF THE STATE OF CALIFORNIA.
SIGNATURE PE 1T VALIDATION CK. M.D. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH
0.5 55 MAR .. 8 4.:y 9 19.50 "