HomeMy Public PortalAbout9861 VAL ST_Mechanical__ 76A364��k
CE-818(W.11/78)
®s APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING / ///J.k7.
(PRINT
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
.. CROSS ST.
ABSORPTION UNIT,BTU OWNER
AIR HANDLING UNIT,CFM MAIL �/ / /n.�
ADDRESS (eye
BOILER,BTU CITY"�� /I11.��! TEL.NO.L�IEI�y-/
COMPRESSOR,BTU CONTRACTOR 0GaAJ
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU GRAVI /► p Q STATE LIC.
FLOOR BTU —� CJ LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH �f
FINAL ! fes V
INSPE TION RECORD
Plan check fee 25%of above.
PERMIT ISSUING FEE$
TOTAL FEE p0 `
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY ��i' /Wl Lf TyTEL.NO+i/
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND ;28200A00A
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY'WITH ALL .` 0 0 0 0 41
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING.' PERMIT VALIDATION 2 0 0 170 0- .
•I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE
OF THE STATE OF CC6�IFORNIA. 0 0 q 7 0 1 1,r0C czi
SIGNATURE
OF PERMITTEE �/,` l 212 2- / 9 _
llGss•(((���(/
)ISTRICT NO. PROCESSED BY