HomeMy Public PortalAbout5633 PERSIMMON AVE_Mechanical__ 76 364--�I,•Cogiv- 9-71
APPLIC ION FOR P MIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS !!dd
BUILDING AND SAFETY DIVISION LOCALIT
NEAREST ,
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL ��3n
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CIT -� EL. NO.a177f. `/ V
COMPRESSOR, BTU
STATE / LIC.
LICENSE NO. ` � CLASS ZL7 ~
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE SSED BY
O$ .� I
EVAPORATIVE COOLER �
1 FURNACE: FAU Aff GRPLVITY �� v
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT_ FCD
WALL v
W
GL
N
• Z
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 3 00
TOTAL FEE mcg
PLAN CHECK APPLICANT
NAME
ADDRESS
CI TY 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 D TE IN ECTOR'S SIGNATURE
EATING, AIR.CONDITIONING.
ROUGH
ALA
CERTIFY THAT I AM NOT ACTING VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS t OF SSIONAL FINAL
CODE OF THE STATE 0 F R .
SIGNATURE PERMIT VALIDA 1 cK. M.O. CASH
OF PERMITTE i
PLAN CHECK VALIDATION CK. M.O. CASH
L-Ar .1:.2.9 473 11123 4. nDl 3.0 0,,. CA
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE