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6A364-CE818-1-68 APPLICAT-CON FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS. b
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITYNEAREST
FOR APPLICANT TO FILL IN CROSS ST.
(Print or type only)
OWNER
NO.. TYPE,OF APPLIANCE OR EQUIPMENT FEE
MAIL /
ADDRESS 1.
ABSORPTION SYSTEM, BTU CITY TEL. NOZ
AIR HANDLING UNIT, CFM CONTRACTOR tG
BOILER, HORSEPOWER ADDRESS
COMPRESSOR, HORSEPOWER O3 CITY AkeArAq/ e TEL. NO -7
STATE LIC.
VENTILATION SYSTEM LICENSE NO. CLASS
DISTRICT NO. I GROUP ZONE ESSED BY
EVAPORATIVE COO ER
FURNACE: FAU GRAVITY
FLOOR—BT �J• G� ^�Z �`�'
U CL
��' �� INSPECTION RECORD v
HEATER: SUSPENDED UNIT
WALL O
v
W
CL
CO)
Z
- D-
0 0 � v p o✓
NEW—ADDITION PERMIT $ 3 00
ALTER—REPAIR— TOTAL FEE $ '
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
HEATING, VENTILATING, AIR CONDITIONING.
1 HEREBY CERTIFY HAT I AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISI ,LIOF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE C FORNIA. APPROVALS DATE INSPECTOR'S SIGNATURE
SIGNATURE F ROUGH - �
FI NAL _
OF PERMITTEE y - /-
�IALIDATION JACK R. ALLEN
CK�I.0. CASH SUPERVISING MECHANICAL ENG'R.
7 .0 5 F.E8 5 4 .(}
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE_