HomeMy Public PortalAbout9755 VAL ST_Mechanical__ 7bA364 - CEBIB - 3-69 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES FADDRESS
DING
DEPARTMENT OF COUNTY ENGINEER RESS
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER ALITY
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGREST
FOR APPLICANT TO FILL IN ER
(PRINT OR TYPE ONLY)
L
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
ABSORPTION SYSTEM BTU CITY TEL NO
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER HORSEPOWER ADORE 5 2
CIT t, TEL NO�� ��/
COMPRESSOR, HORSEPOWER STATE LIC
LICENSE NO J7 CLASS G �0
VENTILATION SYSTEM DISTRICT NO GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER </
FURNACE FAU G ITV
FLOOR BTU —� INSPECTION RECORD
HEATER SUSPENDED_ NIT_
WALL }
O_
O
V
O
H-
U
w
D_
NEW_ADDITION_ PERMIT 5 1 3 00 Z
ALTER_REPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AMD STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALSAT ECTOR' SI NATURE
LATING AIR CONDITIONING
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF ROUGH p
CNA PTER 9 DIVISION 3 THE BUSINESS AND PROFESSIONAL I
FINAL
CODE OF THE STATE ALIFO
SIGNATURE JACK R ALLEN, SUPEAVIUU MECHANICAL ENG'R
OF PER MITT
PERMIT VALIDATION D M D CASH
PLAN CHECK VALIDATION
LAS{, 4 8 3 8F- HAT 7 4 1 D 7.0 0;�- V
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE