HomeMy Public PortalAbout9851 OLIVE ST_Mechanical__ 76:A3dE4ij-"6:E.@,J8 - 9-71 N •• {. y6��`�L�-."'�K/
- APPLICATION FOR • ERMIT
v HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST. C , V
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRE $
CIT TEL. NO.
ABSORPTION UNIT, BTU
CONTRAC R
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
e" eg�
COMPRESSOR, BTU STATE LIC.
LICENSE NO. CLASS Zj
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER _
FURNACE: FAU_GRAVITY INSPECTION RECORD V
FLOOR BTU
HEATER: SUSPENDED UNIT_ CD
WALL v
w
.�5advLU z
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE $ 3 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY 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.
ROUGH CJ_
I 'HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 41,79F THE BUSINESS AND PROFESSIONAL FINALEJ
CODE OF THE STATE OF LI ORNIA. .
SIGNATURE PERMIT VALIDATION CK. M.0. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.0. CASH
►.�('�, 3 1 2 8 7 SEP �.�, 4. 1 D .Ci.0 a
SEE BACK OF APPLICATION FOR COMPLETE-FEE SCHEDULE