HomeMy Public PortalAbout9233 ROSEGLEN ST_Mechanical__ 7eA3e4-c Sia—I/70 APPLICAT.10H FAR PERMIT
HEATING - VENTILATING - AIR coN.D. rIGNING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADE)RESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY EN.GIN[CR
COLEMAN'W, JENKINS, SUKRiINTtNDOINT 04- Su ILrImm NEAR I ►
CROSS ST.
FOR APPLICANT TO FILL IN_ owN
(PRINT OR TYPE ONLY) MAIL
NO. TYPEOFAPPLIANCE.OR EQUIPMENT FEE ADDR
CITY T, NO.
ABSORPTION SYSTEM, BTU
CONTRACTOR
AIR HANDt-JNG "IT, CFM ADDRESS � y
BWLER, HOkSEPOWER CITY
TEL.
COMPRESSOR,'HOASEPOWER SLIC.
LiOE E N SfJ A
VERTILATION SYSTEM DISTRICT NO. CLAMSR ZONE P OC BE ST
EVAPORATIVE COOLER
FURNACE: FAU—GRAVITYINS�l�TION RKCORD
FLOOR BTU
HE=ATER: SUSPERDLO UNIT_
WALL
NkW_ADDITION— PERMIT s 9 00
.AL,TER—RF,PAIRT_ ,TOTAL FEE $ .
PLAN CHECK APPL.IC,ANT
NAME
ADDRESS.
CITY TEL.NO.
I.HEREBY ACKNOWLIDSE THAT I FF�AAVI REAR THIS APPLICATION
AND- STAT[ THAT THE ADOV[ IS CO#J1[CT AND AGREETO COMPLY
WITH ALL ORDINANCES AND 'LAWS [SULATINS HtIATINS,.VENTI- APPROVAI-B DAT[ NOP[CTOR'f SNII�T{1RI
LATINS, AIR CONDITION014'.
RO UG H-
I HERESY CERTIFY THAT I AM' NOT ACTING IN VIOLATIOM
'OF CHAPTER 9, DIVISION S, dr THE BUSINESS AND PRO NAL VINAL
BODE OF THE STATR,OF•CA RN '
SIGNATURE JACK R.,ALLQ4,$UPERVI3 RANI CAL ENO'R-
oF PgRMITtE PERMIT VALIDATION CK. M,0. CASH
PLAN CHI=CK-VALIDATION
SEI BACK OF APPLICAT"FOR fou PL vi FIE SCHEWLE -
76A364C
CE-816 REV.11 78)
cS APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS 'y
(PRINT OR TYPE ONLY)
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER,BTU CITY "-- TEL.NO.
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS,
EVAPORATIVE COOLER CITY f TEL.NO.
FURNACE: FAU GRAVITY STATE _ LIC.
FLOOR BTU I LICENSE NO. CLASS
HEATER: SUDATE
SUSPENDED UNIT__ APPROVALS
ALL INSPECTOR'S SIGNATURE
ROUGH O
FINAL V
W
INSPECTION RECORD
OL
Plan check fee 25% of above. c�
PERMIT ISSUING FEE$
TOTAL FEE F
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL.NO. y�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND '�➢ f �,{^A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR a
CONDITIONING. PERMIT VALIDATION
I HEREBYCERTIFY THAT I AM NOT ACTING IN VIOLATION OF N
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CALIFORNIA.
SIGNATURE
OF PERMITTEE
DISTRICTNO. PROCESSED RV