HomeMy Public PortalAbout5329 WELLAND AVE_Mechanical__ 76A864C
CE-818(REV.6/76)
®5 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES /�BU DIN FETYIDC a7j�kel
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FOR APPLICANT TO FILL IN BUILDING j-3
DDRESS
(PRINT OR TYPE ONLY) A
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
'ABSORPTION UNIT,BTU
OWNER ^( .�
AIR HANDLING UNIT,CFM MAIL
ADDRESS 51
BOILER,BTU // • CITY TEL.NO.
COMPRESSOR,BTU70 9 , CONTRACTOR INO 6d G dam/
VENTILATI.ON SYSTEM ADDRESS �Qr f Aq o f
EVAPORATIVE COOLER CITY vl✓ ?.1?Q 6 TEL.NOT/ 1%4_
FURNACE: FAU G AVITY STATE ? ( LIC. /►
FLOOR BTU O LICENSE NO.J 7V CLASS (�
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH
FINAL O
INSPECTION RECORD w
99
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Plan check fee 25% of above. f.f
r
PERMIT ISSUING FEE n .� 1z
TOTAL FEE ±:;-
PLAN CHECK APPLICANT PLAN CHECKVALIOATION y .�
NAME
ADDRESS
CITY TEL.NO. `.7 910.5 _77 . ~4�
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND `
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALLg
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR /
CONDITIONING. PERMIT VALIDATION,I - iS
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF -ice= `7"1
CHAPTER 9, DIVISIO OF THE BUSINESS AND PROFESSIONAL CODE t
OF THE STATE OF C�X�
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SIGNATURE .. Y7 �7 O J,
OF PERM ITTE (� �i a V
DISTRICTNO. OCESSED Y [�
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