HomeMy Public PortalAbout9703 VAL ST_Mechanical__ tE A3BA - cE ele-+ns APPLICATIFOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
UIL IN D
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
N EAR EST
GROSS ST
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE&SIZE OF EQUIPMENT FEE ADDRESS
SEE BACK OF APPLICATION
FORCE AIR FURNACE BTU 0
g?6 CITY TEL NO
CONTRALTO
COMPRESSOR BTU
ADDRESS � �a
VENTILATION FAN CITY OD EL NO
LIST ALL OTHERS BELOW STATE LIC
LICENSE NO GLASS c'ZD
`DISTRICT NO z ONE no !o
. a� Q-
INSPECTION RECORD
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Plan check fee See reverse
PI-I{111 I ItiSI IN( F I I S "loo
IDI 11 III
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALS DATE PECTOR 8 SIGNATURE
LATINO AIR CONDITIONING
ROUGH _" +
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION /�
OF CHAPTER B DIVISION 3 OF THE BUSINESS AND PROICSSIONAL FINAL y-�s-�
CODE OF THE STATE OF C1L
SIGNATURE PERMIT VALIDATION cK M o DaH
SIOF PERMITTEE.
PLAN CHECK VALIDATION CK M 0 CASH
8 3 601DAUG Ori ' 1 3.0 0