HomeMy Public PortalAbout9563 PENTLAND ST_Mechanical__ 76 A364- CE 818-1/75
APPLI ION FOR PER
HEATING - 'VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) MAIL
NO. TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION
J O.
FORCE AIR FURNACE, BTU Q CITY �. S
CONTRACTOR
COMPRESSOR, BTU ' '
ADDRESS LQ �77p
VENTILATION FAN CITY TEL. NO 3/
LIST ALL OTHERS BELOW -STATE LIC.
LICENSE NO. CLASS
6
DISTRICT N0. GROUP ZONE j O&C SED BY
j�Q (2�
INSPECTION RECORD
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Plan check fee. See reverse. z
PI:IIUI'F ISSliI\G FEE E S 09
TOTAI, FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE A'BOV'E IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS 'D TE SPE TOR'S SIGNATURE
LATING,AIR CONDITIONING. /
Iq
ROUGH ,
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION _
OF CHAPTER 9, DIVISI0 OF THE U INESS AND PROFESSIONAL : FINAL
CODE OF THE STATE OF CA IF NIA' -
SIGNATURE PERMIT.VALIDATION CK. M.0. CASH
OF PERMITTEE
PLAN CHECK ALIDATION 6K. M.G. CASH
2.2 61"MT 20 41:'D 2.3 2 5