HomeMy Public PortalAbout10206 RANDWICK DR_Mechanical__ 75 A�#VSCE 818-1/'75
APPLICA ON FOR PERMIT
HEATING - VENTILATING -. AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER aADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST 4
CROSS ST. 1 ej�
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYRE ONLY) /�
NO. TYPE&SIZE OF EQUIPMENT FEE ADDRESS ►Y�v vv,
SEE BACK OF APPLICATION
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FORCE AIR FURNACE, BTU CITY TEL. NO.
CONTRACTORS
COMPRESSOR, BTU ?k- t
ADDRESS
VENTILATION FAN CITY / TEL. NO. -X:?
LIST ALL OTHERS BELOW- STATE LIC.-CLA "
LICENSE NO.
DISTRICT NO. GROUP ONE PROCESSED BY
08
INSPECTION RECORD
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Plan check fee. See reverse. z
PE:1[\11'I' i45[.ING FE:I: S
TOT,1I, IEE: d
' PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 7j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DA 'f PVTOR'Syi,14<TARE
LATING.AIR CONDITIONING. �•
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION ROUGH `
OF CHAPTER 9, DIVISION 3, O THE U ESS AND P FESSIONAL FINAL
CODE OF THE STATE OF CALI RNA
SIGNATURE PERMIT VALIDATION CK. M.O.v CASH
OF PERMITTEE
PLAN CHECK ALEDATION CK. M.O. CASH
68 '7nMAY 441 D 12.0 0 A'18
JP ✓ d-
76A964E ICE-e18A1-11/76 c , APPLICATION FOR PERMIT
` HEATING - NTILATING - AIR gQITIONING
• COU TY LOS ANGELES
DEPARTMEN F COUNTY ENGI R
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING 102
O L
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE X SPE
NEAREST
• CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER,BTU
CITY TEL.NO. X710
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED UNIT- DISTRICT NO. GROUP ZONE oCESSED BY
WALL ..�
INSPECTION RECORD �-
I
Plan check fee 25%of above. �
PERMIT ISSUING FEE$
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
LORDNAN
T THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ES AND LAWS REGULATING HEATING, VENTILATING, AIR
ING.
EBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODEROUGH
TE OF CAL NIA.
E FINALTT
PLAN CHECK VALIDATION Ci. M.O. CASH'
hOEMMOMMMOiNIPERM IT VALIDATION cK.' M.O. CASH
00 ca rhiAR 9 4 41 D 2 7.0 0 Atld
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