HomeMy Public PortalAbout9521 WEDGEWOOD ST_Mechanical__ Tri
76A964C
CE-8181REV.6/78)
®� APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN, BUILDINGWo
(PRINT OR TYPE ONLY) ADDRESS•LOCALITY J //NO. TYPE OF APPLIANCE OR EQUIPMENT FEE T L C 1 '7-YNEAREST
CROSS ST.
ABSORPTION UNIT,BTUOWNERAIR HANDLING UNIT,CFM MAILADDRESSBOILER,BTUCITY TEL.
COMPRESSOR,BTU CONTRACTOR
N �P ooLs A)r .
VENTILATION SYSTEM � ADDRESS /5 � ��rh��-
EVAPORATIVE COOLER CITY Z Jr TEL.NO. t/-
FURNACE: FAU GRAVITY STATE ^ LIC.
FLOOR BTU LICENSE NO. ��S CLASS C-53
HEATER: SUSPENDEDUNIT
WALL _ APPROVALS DATE INSPECTOR'S SIGNATURE
ROUGH
FINAL O
INSPECTION RECORD, to
In
Plan check fee 25%of above.
PERMIT ISSUING FEE$ 1 71 —
____TTOTAL FEE � •� — ,
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS -16 S 'rV O
,CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT IS CORRECTALL
ORDINANCESTHE ANDSOVE LAWS REGULATINGD HEATING. VENTAGREE TO ILAT NIGH AIR _R 3 6 S.2 A
CONDITIONING. PERMIT VALIDATION
I HEREBY CERTIFY AT I AM NOT ACTING IN VIOLA OF # 0 0 0 0 4
CHAPTER 9, DIVISION , OF THE BUSINES A 0 SIO CODE
OF THE STATE OF CA ORNI . 2 p - 2700
SIGNATURE
OF PERMITTEE
0 0027,006
DISTRICT NO. PROCE SED BY.
D � � 010 2=74
G,V64-CM t,_8-68 'APPLICATION FOR PERMIT ,
HEATING - VENTILATING - AIR CONOITIONIN
L\ COUNTY OF;LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS / D
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING j
LOCALITY av
NEAREST
��//
FOR APPLICANT TO FILL IN CROSS ST. illn
(Print or type only)
OWNER _I, e ��
NO.. TYPEJOF APPLIANCE OR EQUIPMENT FEE
MAIL `
ADDRESS
ABSORPTION SYSTEM, BTU CITY �a TEL. �,
AIR HANDLING UNIT, CFM CONTRACTOR
BOILER, HORSEPOWER ADDRESS
COMPRESSOR, HORSEPOWER CITY TEL. NO.
STATE LIC.
VENTILATION SYSTEM LICENSE'NO. CLASS
DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOLER ®
FURNACE: FAU GRAVITY � f
FLOOR—BTU INSPECTION RECORD
HEATER:.SUSPENDED _UNIT
WALL
9-
o_
CD
V
IY
O
C.
W
O.
y
Z
NEW—ADDITION— PERMIT. $ 3 JJ00
ALTER—REPAIR— TOTAL FEE 3 uV
Plan check applicant
Name
Address
City Tel. No.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING,AIR CONDITIONING. ROUGH
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION FINAL i
OF CHAPTER 9, DIVISION 9, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE OF CALIFORNIA. JACK R. ALLEN,SUPERVISING MECHANICAL ENG'R.
SIGNATURE -.PERMIT VALIDATION
M.O. CASH
OF PERMITTEE
PLAN CHEC ALIDATION
-9 6 9 3,c-- APR 2 6 4 1 D 6.0 ON a .
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE