HomeMy Public PortalAbout4818 PERSIMMON AVE_Mechanical__ 76•A3fv4 -.'LE 8118 -`9-71 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FEAREST
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION C
,
FOR APPLICANT TO-FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR o
AIR HANDLING UNIT, CFM / R
ADDRESS z ��' DIZ,
BOILER, BTU CITY TEL. NO. d" ?
COMPRESSOR, BTU STATE' LIC.
LICENSE NO. rL G �-( CLASS 6
VENTILATION SYSTEM DISTRICT N0. GROUP �ZONE PROCES D BY
EVAPORATIVE COOLER OrI CD
o..
FURNACE: FAU_GRAVITY INSPECTION RECORD C..)
FLOOR BTU
HEATER: SUSPENDED N T i�V
WALL V v
W
On
G7
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Plan check fee 25%of above. See reverse.
PERMIT ISSUING FEE Se 3 00
TOTAL FEE r C)
PLAN CHECK APPLICANT
NAME .
ADDRESS
CITY TEL.NO.
1 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- APPROVALSD TE I ECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
I HEREBY CER Y HAT 1 AM N07 ACTING 1 IOLATIOROUGH
N
OF CHAPTER 9, I5
I0 3, OF THE BUSINESS A FESSIONAL FINAL -
CODE OF THE S TE 0 CALIFORNIA.
SIGNATUR PERMIT VALIDAT K. M.D. CASH
OF PERMI EE
PLAN CH C VALIDATION CK. M.O. CASH
i.�[;D05 -37 WJAN 1241 D 58.00N 4
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE