HomeMy Public PortalAbout6166-6168 ROSEMEAD BLVD_Mechanical__ 76A964E LGE b¢7 BA)-9/77 APPLICATION FOR PERMIT
. •' HEATING - VENTILATING - 'AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
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LOCALITY / `
7NOTYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
• CROSS ST.
ABSORPTION UNIT.BTU
OWNER
AIR HANDLING UNIT,CFM MAIL d
ADDRESS -2 / AQr((�
BOILER,BTU Z 7m, �`b (�
CITY TEL.NO.
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESSloot
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EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU AVITY STATE LIC.
x FLOOR BTU F " LICENSE NO. CLASS
HEATER: SUSPENDED UNIT- DISTRICTNO. GROUP ZONE ROCESSED BY
WALL
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INSPECTION RECORD O
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1
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Plan check fee 25%of above.
9
PERMIT ISSUING FEE$ Z
TOTAL FEE
PLAN CHECK APPLICA
NAME
ADDRESS
CITY Y+� TEL.NO.
IHEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY TH M NOT ACTING ION OF APPROVALS DATE INSPECTOR'S SIGNATURE
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CHAPTER 9 DTVI TH USIN SS FESS AL CODE ,r-
O FCALIFO N ROUGH
SIGNATURE FINAL
OF PER
PLAN CHECK VALIDATION CK. M.O. CASH. PERMIT VALIDATION• ' nl.o. CASH
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