HomeMy Public PortalAbout5300 ROSEMEAD BLVD_Mechanical__ 76A364 - CF-818'- 1-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITI, ING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER .
(PRINT-OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY TEL. NO.
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS CJ
BOILER, HORSEPOWER
CITY TEL. NO
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE N0. CLASSd
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE 0 SED BY
EVAPORATIVE C0 LER I U,
FURNACE: FAU G R.A V TY
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT
WALL }
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NE4 ADDITION_ PERMIT $ 3 00 Z
ALTER_REPAIR_ TOTAL FEE $ C7t
\'PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0. I,
IHEREBY 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,VENTI-
LATING, APPROVALS DATE INSPECTOR'S SIGNATURE
AIR CONDITIONING.
I HEREBY CERTIFY THAT AM NOT CT 11 V10 TION OF ROUGH 1
CHAPTER.9, DIVISION 3, THE B NE P ESSIONAL FINAL C.l
CODE OF THE STATE OF IFORNI4f 4z
SIGNATURE JACK R. ALLEN, SUPER TIM CHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK 'ATION QQ E
er,," 0,2 6,`r13 i�AR�.9, 4 1 2 C.,).0 O A Sr
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE