HomeMy Public PortalAbout5012 WILLMONTE AVE_Mechanical__ 76A364C•-
CE-8181REV.6/78) -
®s A ICATION FOR' RMIT
HEATING.- VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ' BUILDING AND SAFETY
FOR APPLICANT TO FILL.IN ADDRUILIESSSS
ADDRJ 6lyA �fLL/-Y0Adr,6 /4
(PRINT OR TYPE ONLY) ,
LOCALITY
NO. TYPE OF APPLIANCE OREGIUIPM ENT FEE iy
NEAREST
' CROSS ST.
ABSORPTION UNIT,BTU ' L
OWNER R•'� �5� �/��
AIR HANDLING UNIT,CFM MAIL
ADDRESS
BOILER,BTU CITY A Ilp".6T/ TE
COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS 4
EVAPORATIVE COOLER CITY' TEL.NO.
FURNACE: FAA GRAVITY STATE LIC.
FLOOR BTU ILICENSE NO. CLASS
HEATER: SUSP 'sem APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH
FINAL
INSPECTION RECORD u
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l�C9
Plan check fee 25%of above: �
PERMIT ISSUING FEE to
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME
ADDRESS
CITY TEL.NO.
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH-ALL -2 7 2 7.5 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION Wo - 41
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF
CHAPTER 9, DIVISIOL OF THE BUSINESS AND PROFESSIONAL CODE
dF THE STATE OF ORNIA. Z ° - 27.00
SIGNATURE -
OFPERMITTEE O o 027.000
DISTRICT NO. A PR BY
10, 17-79