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76 0.36 - CF•!,'Jp - B )I APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST -
CROSS ST [+ r
FOR APPLICANT TO FILL IN OWNER ` ��
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
♦MD STATE THAT THE AMOVE 1 CORRECT AND AGREE TO COM
WITH,ALL ORDINANCES AND LAWS REGULATING HEATING VEAPPROVALS 0 Tf ISRECTOR% NATURE
LATIO •IR CONDI T IONINO
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HEREBY CERTIFY THAT I •M NOT • IM I IDU
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BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A364-CE8I8-I/70 APPLICATION FOR PER _
HEATING - VENTILATING - AIR CONDITIONING
7,
COUNTY OF LOS ANGELES BUILDING `„
DEPARTMENT OF COUNTY ENGINEER ADDRESS I
BUILDING AND SAFETY DIVISION LOCALITY B If
JOHN A LAMBIE COUNTY ENGINfHR NEAREST '
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING CROSS
FOR APPLICANT TO FILL IN OWNER Will j d V GON
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No YPE OF APPLIANCE OR EQUIPMENT PEE ADDRESS
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ABSORPTION SYSTEM BTU
CONTRACT
AIR HANDLING UNIT, CFM
ADDRESS
BOILER HORSEPOWER CITY TEL NO
COMPRESSOR, HORSEPOWER JATE LIC
ENSE NO CLASS
VENTILATION SYSTEM RICT NO CLASS RD P ZONE PROCESSED BY
EVAPORATIVE COOLER D� 2—
FURNACE
FURNACE FAU_GRAVITY
FLOOR BTU INSPECTION RECORD
HEATER SUSPENDED_UNIT `
WALL
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NEW _ADDITION_ I PERMIT $ 3 00 h
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ALTER_REPAIR_ TOTAL FEE S
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NL
I HEREBY ACKNOWLEDGE THAT I HAVE READ ION
AND STATE THAT THE ABOVE la CORRECT AND PLY
WITH ALL ORDINANCE! AND LAWS REOVLATINSTI APPROVAL* D TE I PECTOR' S TURK
LATINO AIR CONDITIONING i
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I XEREBY CERTIFY THAT I E NOT ACTION IT
OF E0FTH 9 DIVISION 9 GI THE BUSINESS MAL
CODE OFTX[ *TATS OI CALIIORMIA
SIGNATURE // ACK R ALLEN,SUPERVISI HANICAL ENG'R
OF PERMITTEE WRMIT VALIDATION cK M 0 CASH
PLAN CHECK VALIDATION `
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