HomeMy Public PortalAbout9027 RANCHO REAL RD_Mechanical_1974-04-22 76 A384- CE 818- 5-73
A P= AT10NF
OR P IT
HEATING - VENTILATING - AIR O.NOITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS.
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER -
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
CITY TEL. NO.
ABSORPTION UNIT, BTU
CONTRACTO
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CIT TEL. NO.,72;
COMPRESSOR,'BTU STATE LIC.
LICENSE NO.,2W( CLASS�` J
VENTILATION SYSTEM DISTRICT NO. UP ZONE PROC ED BY
EVAPORATIVE COOLER
FURNACE: FAU_GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT_
WALL }.
a.
CD
CD
CD
F-
' W
CL
N
Z
Plan check fee 25% of above. See reverse. '
PERMIT ISSUING FEE $ 3 00
TOTAL FEE GSDI
PLAN CHECK APPLICANT
NAM
OOF
ADDRESS
CIT TEL.N
I 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, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING. -
ROUGH
I HEREB RTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, SION 3 OF THE BUSINESS AND•PROFESSIONAL FINAL ��II ��// `�' II"--•)
CODE OF THE STAT A. C�"•C'� Y •.✓�f •1,��'�"I�
SIGNATURE PERMIT VALIDATION t/ M.O. CASH
OF PERMI TEE -
PLAN CHECK VALID CK. M.O. CASH
6-3 3 VXAFR .2.2. 4.1, D - 1 0.5 0 A88
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE