HomeMy Public PortalAbout6057 PRIMROSE AVE_Mechanical__ 76 A364,.- CE 818- 5-73
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS V
DEPARTMENT OF COUNTY ENGINEER
'BUILDING AND SAFETY DIVISION LOCALITY c�
NEAREST L
CROSS ST. '
FOR APPLICANT TO FILL IN OWNER. .
(PRINT OR TYPE ONLY)
MAIL c
NO. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS D
) I ABSORPTION UNIT, BTU CITY TEL. NO. v f
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
rvuBOILER, BTU CITY TEL. NO.
COMPAESSOR, BTU STATE V LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZINE P CESSED BY
EVAPORATIVE COOLERQ
/ FURNACE: FAU GRAVITY
FLOOR BTU U INSPECTION RECORD
HEATER: SUSPENDED UNIT_
WALL
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Cd
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V
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CL
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE•$ 1 3 00
TOTAL FEE Q U
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND-LAWS REGULATING HEATING, VENT[- APPROVAL'S DATE -INSPECTOR'S SIGNATURE
LAT..6,AIR CONDITIONING. -
ROUGH
I HEREBY CERTIFY AT I AM OT ACTT IN VIOLATION _.
'OF CHAPTER 91 DIVISIO 3 OF THE B 1 A PROFESSIONAL FINAL
CODE OF THE STATE OFC 'IF RNI
SIGNATURE PERMI VALIDATION CK. M.0. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK; M.0. CASH
4:1 0; 8.0 0 A28