HomeMy Public PortalAbout6350 TRELAWNEY AVE_Mechanical__ 76A364C ,�i
CE_818)REV 11,78) PPLIC ON FOR
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HEATING - VENTILATING - AIR C DITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING /1�^� �A n
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LOCALITY
FNOTYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
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ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL "�j��
ADDRESS
BOILER BTU CITE Q + TEL N
COMPRESSOR BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER GIN )` TEL NO
FURNACE FAU_GRAVITY STATE LIC
FLOOR BTU LICENSE NO CLASS
HEATER SUSPE—
�E`�_ APPROVALS DATE INSPECTOR 5 SIGNATURE
WALL
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6
FINAL � O
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INSPECTION RECORD p�
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Plan check fee 25% of above
PERMIT ISSUING FEE;
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK
KVVALIDWA ON
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ADDRESS C � ✓ fir/
CnY TEL NO
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS"PLICATION AND (t Z a O I1
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL > +J It
ORDINANCES AND LAWS REGULATING HEATING VENTILATING AIR
CONDITIONING PERMIT VALIDATION # * * 41
1 HEREBY ERTIF HAT I AM NOT ACTING IN VIOLATION OF
CHAPTER 9 DI ON OF THE�U INE AND PROFESSIONAL CODE 2 * e 17 00
OF THE STATE F AL
RNIA N
SIGNATURE - 1 7 0 0 5
OFPERMITTEE p
DSTRICTMO PROLE Q 317-80
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