HomeMy Public PortalAbout4912 ROBINHOOD AVE_Mechanical__ A�
76A364 - CE818 - 3-69
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FDN
DEPARTMENT OF COUNTY ENGINEER JOHN ABUILDINLMBIIE CUNY ENGIINEER G AND SAFETY DIVISION COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDINGNEAREST
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FOR APPLICANT TO FILL IN /�
(PRINT OR TYPE ONLY) OWNER
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS �� u
ABSORPTION SYSTEM, BTU CITY TEL. NO. Z
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS
BOILER, HORSEPOWER �. 'aA
CITY TEL. NO. '
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM DISTRICT No. GROUP 21 ZONE PROCESSED BY
EVAPORATIVE COOLER /f Aoie If l a_FURNACE: FAU GRAVITY l/ ✓ l
FLOOR BTU IN ECTION RECORD
HEATER: SUSPENDED. UNIT
WALL >
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NEW—ADDITION— PERMIT $ 3 00 Z
ALTEREPAIR_ TOTAL FEE $ ®Q
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
IHEREBY 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-
LATING, A-IR CONDITIONING. APPROVALS DATE SPECTO S IGNATURE
IHEREBY CERTIFY THAT I NOT CTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION , T E BU IN S AND PROFESSIONAL FINAL
CODE OF THE STATE OF!' RNIA.
SIGNATURE 2, JACK R. ALLEN, SUPERVISING MECHANIC L ENG'R.
OF PERMITTEE /'
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
5 7 .6 2Z2 x=10 4 1 0 -7.00-
10
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE