HomeMy Public PortalAbout9706 WEDGEWOOD ST_Mechanical__ 7SA364C
CIE-8181REV.6/78)
®s APPLICATION FOR PER
HEATING VENTILATING - AIR NDITIONING
-COUNTY OF LOS ANGELES.. BUILDING AN AFETY
FOR APPLICANT TO FILL IN'.• aB�oREss
(PRINT OR TYPE ONLY)
LOCALITY "
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT,BTU a
OWNER
AIR HANDLING UNIT,CFM MAIL
ADD SS. n
BOILER,BTU CITY TEL.0(
-60MORESSOR,BT6 / V CONTRACTO
VENTILATION'SYSTEM ADDRESS'
EVAPORATIVE COOLER CITY TEL.N Rte/t�
FURNACE: FAU GR STATE + LIC. �q ee
FLOOR BTU• LICENSE N.OS.. 49 h CLASS.%le
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HEATER:
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL'
ROUGH
FINAL v 0
INSPECTION RECORD V
61 Q:
I
Plan check fee 25%of above. t, M
PERMIT ISSUING FEE$
TOTAL FEE-
PLAN CHECK APPLICANT PLAWCC.yI/y'�I�E.�CK VALIDATION'
NAME .-t$Z!Cj �`."' � •
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANDSTATE THAT IS CORRECT '1 p
t ALL
ORDINANC STHANDBOVE LAWS REGULATINGD EATING. 'VEN ILAT NAGREE TO COMLYIGH AIR 54 7.5 n
CONDITIONING. I PERMIT VALIDATION
1 HEREBY CERTIFY THAT I -AM -NOT ACTING IN VIOLATION OF- o 0 0 0 4 1
`CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE'
OF THE STATE OF CALIFOR 2 0 '0 3 7 0 0
SIGNATURE
OF PERM ITTE ,O O'O 7 Z O O,U
DISTRICT NO. PRO -
• 071.6-79
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