HomeMy Public PortalAbout5413 SANTA ANITA AVE_Mechanical__ 76A364C
CE-818(REV.11/78)
®s SAP A fOR PER
HEATING - V NTI NG - AIR. ONDITIONIN
1V1 ;3'
COUNTY OF LOS ANGELES B I G AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
(PRINT OR TYPE ONLY)
LOCALIT
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWN
AIR HANDLING UNIT,CFM MAIL
ADD RESSL�-,J,
BOILER.BTU O/7 ,FJ CITY ♦� TEL.N
COMPRESSOR,BTU v V CONTRACTO
VENTILATION SYSTEM
• ADDRESS �.
EVAPORATIVE COOLER CITY EL.N
/) FURNACE: FAU G Y STAT LIC. '
/ FLOOR BTU LICENSE NO. CLASS
CO—
EATER: SUSPEND D UNIT APPROVALS ATE INS ECT IGNATURE u'
WAL r
ROUGH / O
FINAL. W
INSRECORD 0.
Vl
r z
Plan check fee 25%of above. �^
PERMIT ISSUING FEE$
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME 22 "/
ADDRESS
CITY TEL.NO. 1 0 6 3 A
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND # 0 0 0'0
[) 1
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
ORDINANCES AND LAWS REG NG HEATING, VENTILATING, AIR 2 o o 2 7 O O
CONDITIONING. PERMIT VALIDATION
I HEREBY IFY THAT 1 M N AC o 0 0 `2 7,0 0
CHAPTER 9, SIGN 3, OF BUSI SS AN P FESSIO L CODE
OF THE ST OF CALIF A. ti 0 .7. 02-80
S IGNATUR
OF PERMITT
IISTRICT NO. PROCES