HomeMy Public PortalAbout9040 RANCHO REAL RD_Mechanical_1977-11-21 �� -
76,004 All l 8 18-1/75 '
OAPPLICAT N FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER '
ADDRESS O falO REAL
BUILDING AND SAFETY DIVISION LOCALITY Lp C-t-1711
NEAREST
CROSS ST. U L i
FOR APPLICANT TO FILL IN OWNER C
(PRINT OR TYPE ONLY)
MAI L
N0. TYPE&SIZE OF EQUIPMENT FEE ADDRESS «}O
SEE BACK OF APPLICATION
'n',y�n CITY �� CITy TEL. NO. Z 47 3
FORCE AIR FURNACE, BTU 1SiOM �l�
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CONTRACTOR G Q�
COMPRESSOR, BTU
ADDRESS Zs )j I�L
VENTILATION FAN CITY TEL. NO..
Az v�•�q Q � '733 .
LIST ALL OTHERS BELOW STATELICENSE NO.2-C)* s�0 C/ LIC,
CLASS
DISTRICT NO. GROUP ZONE OCESSED BY
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INSPECTION RECORD
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Plan check fee. See reverse. z
PE.IBIrr ISSUTNG FEE
TOTAI,
PLAN CHECK APPLICANT /oL •D
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-1- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER S, DIVISIO F THE BLLLjjj...44B���NESS AND PROFESSIONAL FINAL
CODE OF THE STATE O C FO I�.
SIGNATURE S/r'� PERMIT VALIDATION CK.- M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH
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