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10 A364 - Ce BIB - 0 71 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY ry,
NEAREST
CROSS ST
FOR APPLICANT TO FILL IN OWNERPr
(PRINT OR TYPE ONLY) AIA vv
MAIL A
No TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY C TEL NO
ABSORPTION UNIT BTU Zj_ LJ510
CONT CT R
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL NO
COMPRESSOR BTU STATE LIC
LICENSE NO CLASS
VENTILATION SYSTEM DISTRICT NO GROUP ZONE
PROCE53ED BY
EVAPORATIVE COOLER 5 Op I 'v L
FURNACE FAU_GR Y 4PECTION RECORD
FLOOR STU— c.a
Y
HEATER SUSPENDED—
UNIT—WALL 4
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Plan check fee 254 of aboYL Se, rc%I r,I
PI 10111 ISSUING FL ' S 3 DD
IOFAI 14FE 13
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH15 APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY
WITH ALL OROINANCES AND AW! REOaLJTINB HEATING VENTI APPROVALS D TE 11 PECTO11331OMTURE
LATINO AIR CONDITI ONI 0
ROUGH
OI CI HEREBY CER IY T I OT • I IN IDEATION
HARTER 9 D IS 0 OI N BIH[ IR [SSIOxAL FINAL
CODE OF THE ST TE I IF 1
SIGNATURE PERMIT VALIDATIO cK M G CASN
OF PERMITTEE
PLAN CHECK VALI ATION CK M 0 CASH
u1l,o n 2 7 4 ;S DEC 21 4 1 D 1 3.0 0�
■EE BACK OF APPLICATroN FOR COMPLETE FEE SCHEDULE