HomeMy Public PortalAbout5430 ROSEMEAD BLVD_Mechanical__ 78A964—CE81B-1/70 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
77
COUNTY OF LOS ANGELES BUILDING '
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. .JENKINS, SUPERINTENDENT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL �y
NO. TYPEOFAPPLIANCE�OR EQUIPMENT PEE ADDRESS .ALV
CITY p TEL. NO. �� .67ABSORPTION SYSTEM, BTU
CONTRALTO
AIR HANDLING UNIT, CFM p.
ADORE S �C�
i
BOILER, HORSEPOWER CITY STATE �J/ ,(TEL. NO., /
/ COMPRESSOR, HORSEPOWER d LICENSE NO. p< (CSO �c1 CLASS
VENTILATION SYSTEM �/ DISTRICT NO. CLASS GROUP ZONE PROCESSED BY v
EVAPORATIVE COOLER fr (/� lr( 0 ) ro_
z1a—A
FURNACE: FAU_GRAVITY INSPECTION RECORD
FLOOR BTU
HEATER: SUSPENDED UNIT_
WALL
ate.
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NEW_ADDITION— PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ OD
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I 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 DAIE I SPECTOR'SaS IGNATURE
EATING, AIR CONDITIONING. it
I HEREBY CERTIFHAT IAM NOT A IN IN VIOLATION OF CHAPTERDVSO
ROUGH F THE BUSINE A PROFESSIONAL FINAL '
CODE OF THE F I ORNIA.
SIGNATURE JACK R. ALLEN,SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION
.0ONSL`Go 9 n v ^I"AY 5 4 1 D 8.00-
SEE
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76 8364 — CE Bib — 9-71 APDL. ATION F�ERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING ,p
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY J
NEAREST
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 UNIT, BTU
CONTRACTOR
AIR HANDLING UNIT, CFM ADDRESS 5 ',,/,,0-'��� ' fyJG'i�`
BOILER, BTU
CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE NO. CLASS
VENTILATION SYSTEM /�d DISTRICT NO. GROUP ESS ED BY
EVAPORATIVE COOLER �CZONE'
P'
FURNACE: FAUGRAVITY
FLOOR BTU INSPECTION RECORD U
HEATER: SUSPENDED UNIT_ o
F--
WALL Lv
rn
Z
Plan check fee 25% of above. See reverse.
PEMMIT ISSUING F'EE S 3 00
` TOTAL FEE
PLANN CHECK APPLICANT
NAME
ADDRESS,-,--
C 1._T
DDRESS,-,-'C1.7 TEL.NO.
I 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 D TE NSPECTOR'S SIGNATURE
LATING, AI ' I
R 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 CALIFORNIA.
OF PESIGNATUREITTEE PERMIT VALI ION M.O. CASH
OF PERMITTEE (
PLAN CHECK VALIDATION CK. M.O. CASH
1 fir c 0 2 873 HPA 16 4 1 D '7.0 0-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE