HomeMy Public PortalAbout9020-9022-9022 1/2-9024-9026-9028 RANCHO REAL RD_Mechanical_1976-01-09 76 A36A- CE 818- 55-73 A
APPLICATION FOR PERMIT �
H ATING - VENTILATING ; AIR CONDITIONING'
V- 2,4—7Zf 77 e—. v
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS t�
BUILDING AND SAFETY DIVISION LOCALIT
Ag e-
NEAREST
CROSS ST.
FOR APPLICANT TO FILL 1N OWNER
(PRINT OR TYPE ONLY) 7 • v'� �^
MAIL �'�(a
No. TYPE OFAPPLI.ANC'E OR EQUIPMENT FEE ADDRESS�� Lr
CITT� ��— ^ EL. NO. (ea Z
ABSORPTION UNIT, BTU
CONTRACTOR
AIR HANDLING U'NI'T, CFM
ADDRESS
BOILER, BTU ` CITY
y % TEL. NOL,zz
COMPRESSOR, BTU fa./�aiSTATE LIC.
LICENSE NO. CLASSIC'--Z, 10
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER ( p�
FURNACE: FAU_GR VI.TY A VV INSPECTION RECOR
FLOOR BTU 4'
HEATER: SUSPENDED—UNIT—
WALL
USPENDED UNIT_WALL
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O
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O
F
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Plan check fee'25% of above.. See reverse.
PERMIT ISSUING FEE 8 3 00
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
LBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ,
E THAT THS ABOVE 'IS CORRECT AND AGREE TO COMPLY
ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTORS SIGNATURE
IR'CONDITIONING. ROUGHEBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
ER 9, DIVI 3, OF THE BUSINESS AND P FESSIONAL FINAL �P"L�THE STAT F ALIFOR NIA.URE ' ERMIT VALIDATION CK. M.O. CASH
MITTE
PLAN CHECK VALIDATION CK. M.O. CASH
.3 "5 9'Xg%.-AW '214 1 "D. 6.3.0 0`A-%
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE