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APPLICATION•FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING NEAREST �GL
CROSS ST
FOR APPLICANT TO FILL IN OWNER L sq7-
MAIL
(PRINT OR TYPE ONLY)NO YPEOFAPPLIANCEOR EQUIPMEN FEE ADDRESS CITY TEL NABSORPTION SYSTEM, BTUCONTRACAIR HANDLING UNIT, CFMADDRESSBOILER HORSEPOWER CITYXZa(ATEL NCOMPRESSOR, HORSEPOWER ® STATE
LICENSE NO
VENTILATION SYSTEM
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EVAPORATIVE COOLER
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FURNACE FAU GRAVITY C INSPECTION RECORD
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HEATER SUSPENDED-
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NEW—ADDITION— PERMIT $ 3 00 y
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ALTER_REPAIR_ TOTAL FEE S
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCCB AND LAWS, REGULATING HEATING VENTI- APPROVALS DATE UM CTd1b 310 TUBE
LATING AIR CONDITIONING
ROUGH
I HEREBY DIVISION
THAT I E NOT ACTIM IN VIOLATION
OF CHAPTER p OIVIIIOM 3 OF THE SUS,I N[S,8 A PRO PROFESSIONAL FINAL
CODE OF THE STATE OP AL PNIIA
SIGNATURE JACK R ALLEN,SUPERVISI N ICAL ENG•R
OF PERMITTEE
PERMIT VALIDATION cN cnsH
PLAN CHECK VALIDATION
LJW 'z 6 3 6-� DEC 13 4 1 0 1 O�
SCC BACK OP APPLICATION POR COM PL"K P[[SCHEW LC