HomeMy Public PortalAbout6002 PRIMROSE AVE_Mechanical__ 76A3134C r v
CE•8I S(REV.6/78)
es APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNE
AIR HANDLING UNIT,CFM MAIL
ADDRESS,
BOILER,BTU
CITY TEL.NO.
COMPRESSOR,BTU CONTRACTOR s✓i��
VENTILATION SYSTEM -)I/) f r' �S 4
ADDRESS �[
EVAPORATIVE COOLER CITY t TEL.NO.
FURNACE: FAU GRAVITYSTATE / LIC. /
FLOOR BTU LICENSE NO. 7�/ CLASSifr� 6
HEATER: SUSPWALL D�F,D U IT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL `�
ROUGH t
FINAL
INSPECTION RECORD
ES
Plan check fee 25%of above. �
PERMIT ISSUING FEE$ g
TOTAL FEE G' d
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
z 7 9 2 9 A
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 Z ° ° 1 7,
ORDINANCES AND LAWS REGUL ZING HEAT VENTILATING, AIR
00
CONDITIONING. PERMIT VALIDATION ° o ° 1 7.Q 0
I HEREBY CERTI TH I M ACTI IN VIOLATION F
C PT
OF THE STATE OFSION CALIFO F HE U N SAND PR SIONAL DE I 1,26-79
SIGNATURE
OF PERMITTEE
DISTRICTNO. PROCESSED B ,�