HomeMy Public PortalAbout9034 RANCHO REAL RD_Mechanical_1975-08-21 76 A384= CE 6,6- 6-78 APPLICATION FOR PERMIT
1o"f'_' z HEATING - VENTILATING - AIR CONDITIONING
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER "
DRESS
BUILDING AND SAFETY DIVISION LOCALITY:�
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN. OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS
CIT G �e-�f EL. NO. 'z
ABSORPTION UNIT, BTU �r
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY e TEL. NO j 3
COMPRESSOR, BTU �'� STATE LIC.
LICENSE NO. CLASS L"3
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER F' —,
FURNACE: FAU_GR ITY
FLOOR BTU D / INSPECTION RE GO RD
HEATER: SUSPENDED UNIT_
WALL
CD
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C
CD
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8 s 00
TOTAL FEE 33
PLAN CHECK APPLICANT
NAME
ADDRESS
CI TY TEL.NO.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING.
ROUGH
I HEREBY CERTIF ' HAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DTVI ON OF THE BUSINESS AND PROFESSIONAL FINAL "�� �Lp.-t:�
CODE OF THE STAT F C LIFORNIA.
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITT
PLAN CHECK VALIDATION CK. M.O. CASH
1 5 8 x--AUu 23:'4.1 3 3.0 Q;A%8
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE `