HomeMy Public PortalAbout6317 SULTANA AVE_Mechanical__ 76A364 --CESIS - 3-69
APPLICATION FOR PERMIT '
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING 7/
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W.JENKINS,SUPERINTENDENT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS
ABSORPTION SYSTEM, BTU CITY ar. 4Tf L. NO.
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS
CITY TEL. NO,4 �rP
COMPRESSOR, HORSEPOWER STAfELIC._ /
LIC NSE N2,4 �: !p CLASS
VENTILATION SYSTEM DISTRICT N0. GROUP ZONE V USED BY
EVAPORATIVE COOLER .09 -17�
FURNACE: FAU GRAVITY W1�
_FLOOR BTU INSPECTION RECORD
HEATER: SUSPE DED UNIT
WALL VO
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- L
U.
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NEW—ADDITION— PERMIT $ 3 00 L
ALTER REPAIR_ TOTAL FEE $ $ 60
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING,VENTI-
LATING;AIR CONDITIONING. APPROVALS DATE PECTO S SIGNATURE
1 HEREBY CERTIFY THAT I.AM NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVISION 3,-OF THE BU NESS AND PROFESSIONAL FINAL
CODE OF THE STATE OF CA I
SIGNATURExf, JACK. R. ALLEN UPERVISING MECHANICAL ENG-R.
OF PERMITTEE -
PERMIT VALIDAT cK. . M.O. CASH
PLAN CHECK VALIDATION
.00-Sr 9 3 '!:,6 OCT � 4 1 0 8.00-
SEE
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE _
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