HomeMy Public PortalAbout5548 SULTANA AVE_Mechanical__ T!A!!IL • �
CB 81G(REV 6n8)
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES' BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING C'
(PRINT OR TYPE ONLY) ADDRESS J
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS
BOILER BTU M C TEL NO
C�
COMPRESSOR BTU CONTRACTOR
VENTILATION SYST ADDRESS r ,
EVAPORATIVE COOL VOVICITY EL NO
FURNACE FAU_GRAVRY' STATE LIC
FLOOR BTU LICENSE NO CLASS
HEATER SUSPENDED—UNIT— I APPROVALS DATE INSPECTOR S SIGNATURE
WALL
ROUGH
FINAL O
INSPECTION RECORD Y
O
Plan check fee 25% of above
PERMIT ISSUING FEE;
)
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATIOAI
`
NAME I ' -- < Ce -4q`q(„•�
ADDRESS 10 i - `� _ D O
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS TION AND I _
STATE THAT THE ABOVE 15 CORRECT AND AGREE TO MPLY ITH ALL
93 19 1 A
ORDINANCES AND LAWS REGULATING HEATING ENTIUTI G AIR
CONDITIONING PERMIT VALIDATION # • • • • 4 1
1 HEREBY CERTIFY AT I NOT ACTI N VIC TION OF
CHAPTER 9 DIVISI F THE NE AN F NAL CODE
OF THE STATE OF NIA 2 * 27.00
SIGNATURE �]
OF PERMITTEE L O O
DISTRICT NO PROLE ED BY 0 31 2-79
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