HomeMy Public PortalAbout5314 WELLAND AVE_Mechanical__ 78A38116 ICE.BiSA).„/'e AP K ICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
A de
_ LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST I
CROSS ST. f�
ABSORPTION UNIT,BTU
-A AAJ
OWNER Q�
AIR HANDLING UNIT,CFM MAIL ^
ADDRESS �(JttlLBOILER,BTU CITY TEL.NO,COMPRESSOR,BTU / V
CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDE UNIT- DISTRICT NO. GROUP ZONE PRO ED BY
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INSPECTION RECORD
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Plan check fee 25%of above. W
PERMIT ISSUING FEE$ w
T®TAL FEE
PLAN CHECK APPLICANT �010
NAME
ADDRESS
CITY TEaAN
I HEREBY ACK OWLEDGE THAT I HAVE REAATION AND
STATE THAT THE A VE IS CORRECT AND AGRWITH ALL
ORDINANCES AND LAWS REGULATING HEATING, AIR
CONDITIONING.
I HEREBY C R IFY THAT I AM NOT ALATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVIS 3, OF THE BUSINES ANAL CODEOF THE STATE OF L FORNIA. 1ROUGH
SIGNATURE MNAI
OF P E RM ITTE �'A
PLAN CHECK LIDATION CK. M.O. CASH MENEM PERMIT VALID 1 cK. ' M. CAS
2281.NMY 444. D 1, 7.0'0 'Af.b
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76 A364r CE BIB- 543 C� /
APP ATION FOR P IT
• HEATING - VENTILATtNEAREST
- A IT
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COUNTY OF LOS ANGELES RESS S
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ALITY
SS ST.
FOR APPLICANT TO FILL IN je
(PRINT OR TYPE ONLY) OWNER + r• �1C�i
MAIL
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE ADDRESS /5- o
CITY / �s / TEL. NO.
ABSORPTION UNIT, BTU !%- ✓
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE NO.., CLASS
VENTILATION SYSTEM DISTRICT NO. GROUPZONE CESSED BY
EVAPORATIVE COOLER Jr S Z `
FURNACE: FAU_G.RAVITY
FLOOR BTU INSPECTION RECORD
HEATER: SUSP.E DED UNIT_
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S 3 00
TOTAL FEE pp
PLAN CHECK APPLI NT
NAME
ADDRESS
CITY T L.NO.
LBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
E THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ORDINANCES AND LAWS'REGULATING HEATING, VENT[- APPROVALS DATE INSPECTOR'S SIGNATURE
IR CONDITIONING. �/ e�,,�EBY CERTIFY THAT I AM NOT ACTING IN VIOLATION ROUGH ' �7� Y/ER 9, DIVISION 3 OF THE BUSINESS AND PROFESSIONAL FINAL Z 3 J THESTATE 0 ALIF NIAURE PERMIT VALIDATION CK.' 'M.O. CASH
MITTEE -•'
PLAN CHECK VALIDATION CK. M.0. CASH
4-°.7APi 2 4. •1 D. 98
8.0 0
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE '