HomeMy Public PortalAbout5027 PAL MAL AVE_Mechanical__ :6A364 - CE818 - 3-69 APPLICATION FOR PERMIT q
HEATING - VENTILATING - AIR CONDITIONING Il
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS La:t
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN
(PRINT OR TYPE ONLY) OWNER
MAIL �"�
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDR -u
ABSORPTION SYSTEM, BTU �,O ClTyie
TEL. NO.
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS
CITY 6
COMPRESSOR, HORSEPOWER ` TEL. NO.
STATE /
LICENSE NO. (, CLASS
VENTILATION SYSTEM
EVAPORATIVE COOLER DISTRICT Ngo./ GROUP ZONEZ
SSED BY
�� f1�J — �)
/ FURNACE: FAU GR VITY ( J �— I
FLOOR BTUSINSPE TION F�ECORD
HEATER: LL NDED UNIT '/O
rli... t`�.! .rte -'%e- C
LL
.� ��r�-�,-� tin •� 0-
NEW—ADDITION:— PERMIT $ 3 00 If j N Z
L L�
ALTER---REPAIR— TOTAL FEE $ � CIO )
PLAN CHECK APPLICANT /I Z '1 &
NAME
ADDRESS
CITY TEL.N0.
1HEREBY 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-
EATING, AIR CONDITIONING. APPROVALS DATE I PE TOR'S SI AT RE
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISID 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE CALIFORNIA.
SIGNATURE P
JACK R. ALLEN, SUPERVI MECHANICAL ENG'R.
OF PERMITTEE PERMIT VALIDATIONCK. LASH
PLAN CHECK VALIDATIONcll
kL6.0.
LACO 2053 UW 141 D 20.00
;EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE