HomeMy Public PortalAbout5515 PERSIMMON AVE_Mechanical__ r C i`j
®� APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND AFETY
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS 6r
LOCALITY � ;TE
A,
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST. i(ABSORPTION UNIT,BTU y�OWNER ////�AIR HANDLING UNIT,CFM MAIL ' s ADDRESSBOILER,BTU CITY /� �/COMPRESSOR,BTU CONTRACTOR(• O
VENTILATION SYSTEM ADDRESS 000
N��EVAPORATIVE COOLER CITY lt;bek ) _ G &
FURNACE: FAU - GRAVITY STATE //��Q LIC.
FLOOR BTU LICENSE NO.Z, (a [ CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH
FINAL
INSPECTION RECORD
B6
O
Plan check fee 25%of above.
PERMIT ISSUING FEE$ z
TOTAL FEE � e
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME-
ADDRESS
CITY TEL.NO.
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND 3 3 IL 3 A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION # D o 0 0 14 1
1 HERCHAPTER 9E DIV S ONBY I 3Y OFAT E B SINE S A DI AM NOT ING IN PROFESSONALON OF
CODE 2 0 o 1 1.00
OF THE STATE OFC LIF R
SIGNATURE0 0 0 1 1,006
OF PERMITTEE
DISTRICT NO. PR ESSED BY
03120-79
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