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®l APPLICATION FOR PERMIT
HEATING - VENTILATING'- AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY L)Aj
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLYI ADDRESS
LOCALITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER J
AIR HANDLING UNIT CFM MAIL _ D
ADDRESS 8L
BOILER BTU CITYTEL NO
X95 4
COMPRESSOR BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITY TEL No
7
FURNACE FAU GRVI STATE �J LIG
FLOOR BTU LICENSE NO Z CLASS l%
HEATER SUSPENDED-UNIT
WALL S AppROVNDATE INSPECTOR 551GNATLRE
ROUGH
FINAL
INSPECTION RECOR15Y
4
Plan check fee 25% of above �+
PERMIT ISSUING FEE f _
TOTAL FEE —
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESSh� N)
CITY TEL NO `
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANDSTATE THAT IS " 11
ALL
ORO NANCESTHE ANDSOVE LAWS ROEGULATINGD HEATING AGREEO VENTPLAT NGCOMLYH AIR 1 4 4 1/ 3 A ,
CONDITIONING PERMIT VALIDATION We e'e e 4 1
I HEREBY CERTIFY TH I M 1 ACTING VIOLATION OF I
CHAPTER 9 DIVISION 3 O H BUS 55 ANO FESSIONAL CODE
OF THE STATE OF CALIFO A L - e - 27.00
SIGNATURE
OF PERMITTEE e • e '27 QOS
DISTRICT NO J JPROCESSED B v 0 5 2 1 _7 9 C1 ,
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®. APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY 611 *�4
FOR APPLICANT TO FILL IN BUILDING i4�
(PRINT OR TYPE ONLY) ADDRESS
--
NO TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY
NEAREST A ^
CROSS ST
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS
BOILER BTU
cITyZ0eAbInL4
TEL NO
ZLJ
COMPRESSOR BTU I _14DO CONTRACTOR -�
VENTILATION SYSTEM
ADORES
EVAPORATIVE COOLER v
CITY GZ TEL NO
FURNACE FAU 9VITYSTATE -LIC /'—� _
FLOOR BTU LICENSE NO- &J
ZO CLASS(.
HEATER SUSPENDED—UNIT— MM0' APPROVALS DATE INSPECTOR S SIGNATURE
WALL
ROUGH
FINAL - Q
INSPECTION RECoF& V
0
Plan check fee 25% of above
PERMIT ISSUING FEE$ _
TOTAL FEE `L —
PLANCHECKAPPLICANT - PLAN CHECK VALIDATION
NAME
ADDRESS T Ca�I✓ S `� /, �+
CITY TEL NO i
w
1 HEREBY E ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE S CORRECT AND AGREE TO COMPLY WITH ALL - -4 4'4 7 4 A
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR
CONDITIONING PERMIT VALIDATION # • •'• 4 1
I HEREBY CERTIFY T 41N
OT CTING IN VIOLATION OF ,
CHAPTER 9 DIVISION 3 E NO PROFESSIONAL CODE n 2 7 Q
OF THE STATE OF CALIF I 2
SIGNATURE
OF PERMITTEE 2 7.0 0 5
DISTRICT No PR oc sED BY I 0 5 21 =7 9