HomeMy Public PortalAbout9679 WEDGEWOOD ST_Mechanical__ 76 A364 - CE 818 - 9-71 10 APPLICATION FOR 7ERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS G� ES-Gr/d
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY / ,. de zt
NEAREST
CROSS ST. � •! LtJ
FOR APPLICANT TO FILL IN OWNER /e
(PRINT OR TYPE ONLY)
MAIL
NO. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS r C g � L:ti'1
ABSORPTION UNIT, BT � � CIT Y'r� Cc- EL. NO'
` 7 S�
CONTRACT R 9 gg "]
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY - TEL. NO.��r/�
COMPRESSOR, BTU STATELIC.
LICENSE NO /7�a CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PROCESSED BY
EVAPORATIVE COOL -I a
FURNACE: FAU_GRAy
FLOOR BTU /�•ITY INSPECTION RECORD v
HEATER: SUSPENDED UNIT_ v
WALL Lu
0-
en
• Z
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 8
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I 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 CERT HAT AM NOT ACTING IN VIOLATION
OF CHAPTER 9, ION OF HE BUSINEAAROFESSIONAL FINAL
CODE OF THE TE 0 L FO IA.
SIGNATURE ` P IT VALIDATION CK. M.O. CASH
OF PERMIT
PLAN CHECK VALIDATION CK. M.tr CASH
5"Q 6DEE, S1 41 1) 1 9.5 0 &�38
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE