HomeMy Public PortalAbout4837 RIO HONDO AVE_Mechanical__ 76A364–CE81 8–1/70 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING �.
COUNTY OF LOS ANGELES BUILDING / r
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY'
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING AV Af
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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 SYSTEM, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, HORSEPOWER CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT NO. CLASS GROUP ZONE PROr
A.PSEF BY
EVAPORATIVE COOLER (!�S 1 J�-t �
FURNACE: FAU GRA ITY /� INSPECTION RECORD
FLOOR U 4
HEATER: SUSPENDED UNIT_
WALL
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NEW—ADDITION— PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ S(�O
PLAN CHECK APPLICANT ��JJ
NAME
ADDRESS
CITY TEL.NO.
1
1 HEREBY ACKNOWLEDGE THAT I 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 CERTIFY THAT I AM NOT ACTING IN VIOLATION `
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF .1 A.
il
SIGNATURE JACK R. ALLEN,S PERVISI M C ANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION' CK. M.O. CASH
PLAN CHECK VALIDATION
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE `