HomeMy Public PortalAbout5816 ROWLAND AVE_Mechanical__ J&n76A364 - CEB1B - 3-69 APPLICATION FOR PERMI
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDINGS/4
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) A-r
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM,. BTU CITY e. TEL. NO of
AIR HANDLING UNIT, CFM CONTRACTOR
ADDRESS
BOILER, HORSEPOWER
CITY TEL. NO.
COMPRESSOR, HORSEPOWER STATE LIC.
LICENSE N0. CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP CESSED BY
EVAPORATIVE COOLER
O T
FURNACE: FAU GRAVITY 0J•
FLOOR BTU INSPECTION RECORD
HEATER: SUSPENDED UNIT
WALL SO
0
C
0
C
u
NEW✓ADDITION_ PERMI T $ 3 00 u
ALTER REPAIR_ TOTAL FEE $ Do
PLAN CHECK APPLICANT
NAME . of
ADDRESS At A uJ/A,,,.,
CITY /C. &l/v TEL.NO..?J6
IHEREBY AC OWLEDGE T AT 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,AIR'CONOITIONING. APPROVALS ATE IN TOR'S S TURE
y
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGHCHA 4�
CODE OF THEPTER 9, DSVATOOF CALIFORNIgOF THE USINESS AND PROFESSIONAL FINAL - y��j 7t - �^��Y�ry4�
SIGNATURE JACK R. ALLEN, SU ERVISIRG• ECHANICAL ENG'R.
OF PERMITTEE `
.17 PERMIT VALIDATIO CK. M.O. CASH
PLAN CHECK ]VALIDATION
4 .9. 6 79 .MAY 18 4 1 D 7.0 Gi^ Z
t
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE