HomeMy Public PortalAbout4937 SERENO DR_Mechanical__ APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDI1IONING
r
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS O
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS STG
FOR APPLICANT TO FILL IN IO+VNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION
CITY TEL NO
FORCE AIR FURNACE BTU
CONTRACTOR
COMPRESSOR BTU
ADDRESS � �Q
VENTILATION FAN CITU } TEL NOW,1 �
LIC
LIST ALL OTHERS BELOW STATELICENSE NO Z '3& c`, CLASS
IY U,s,p,Cl NO 6ROUP SOHOBYNE
� Og �2a
INSPECTION RECORD
Y
a
0
U
O
r
+ U
W
a
Plan check fee- See reverse
I'I Ii\III I��I I�f III 5 0 -
IOI
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACANOWLEOOE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCESAND LAWS REGULATING HEATING VENTI APPROVALS DATE INSPECTOR S SIGNATURE
LATINO AIR CONDITION)N4
ROUGH
I HEREBY CfRTI `THAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9 DIV, IO 3 OF THE BU INE S AND PROFESSIONAL FINAL — 3
CODE OF THE STATE OF ALIF NIA VV
SIGNATURE
OF PERMITPERMIT F LIDATION ( cA Mo E.sH
TE _
PLAN CH CK ALIDATION c M D CASH '`'�
1 1 2�JAN Lcf 4.1 0 1 2. '