HomeMy Public PortalAbout5038 PERSIMMON AVE_Mechanical__ 769364-CESIS-4/70 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
' COUNTY OF LOS ANGELES BUILDING ,,�,/
DEPARTMENT OF COUNTY ENGINEER ADDRESS � � IY70
BUILDING AND SAFETY DIVISION LOCALIT'�- .
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL C�yy,�
NO. TYPE OFAPPLIANCE-OR EQUIPMENT FEE ADDRESSJ /✓� !
CITY TEL:NO.&/-yy��(��
ABSORPTION SYSTEM, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM ADDRESS
BOILER, HORSEPOWER CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. I CLASS GGRRO'UP ZONE PROCESSED BY
EVAPORATIVE COOLER �� ,L �� •
FURNACE: FAU_GRAVITY INSPECTION RECORD
FLOOR BTU
HEATER: SUSPENDED UNIT_
WALL
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NEW—ADDITION— PERMIT $ 3 00 ?
ALTER—REPAIR— TOTAL FEE S
PLAN CHECK APPLICANT V
NAM
ADDRESS
CITY � - L TEL.NO.
I 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- APPROVALS DATE INSPEC R'S SIGNATURE
LA=ING,AIR CONDITIONING.
ROUGH s! r
I HEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION r�
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL Id Id�7 rl
CODE OF THE STATE OF CALIFORNIA.
SIGNATURE JACK R. ALLEN,SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE '
PERMIT VALIDATION . CK. M.O. CASH
PLAN CHECK VALIDATION
069 AN11 41 D 7.0
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE