HomeMy Public PortalAbout5226 WILLMONTE AVE_Mechanical__ Als
76AS64C " +
CE-018(REV.6/78) ,
es APPLICATION FOR PERMIT
HEATING- VENTILATING - AIR CONDITIONING
COUNTY OF LOS.ANGELES ' - BUILDING AND SAFETY
FOR APPLICANT TO FILL'IN BUILDING '
(PRINT OR TYPE ONLY) ADDRESS
LOCAL4N- e 0/
NO. TYPE OF APPLIANCE OR EQUIPMENT FE'E
NEAREST
CROSS ST.
' !Y
ABSORPTION UNIT,BTU J
• - OWNER
AIR HANDLING UNIT,CFM MAIL +
ADDRESS
BOILER,BTU CITY TEL.NO..COMPRESSOR,BTU CONTRACTOR
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.531_$1[l8
a
FURNACE:. FALL GRAVITY STATE' .
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
r ROUGH
FINAL. . M'I�t/�/� / Pali' ji��.
X• /9LtC� INSPECTION RECORD �
• - tY4
LI - U5
Plan check fee 25% of above.
PERMIT ISSUING FEE$ B O
TOTAL.FEE
PLAN CHECK APPLICANT PLAN C14ECK VALIDATION
NAME
ADDRESS .
CITY J TEL.NO.
c C! �j r�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND G 19 4 A
STATE THAT THE ABO . CORRECT-AND AGREE TO COMPLY WITH ALL
ORDINANCES AND AW REGULATING HEATING, VENTILATING,, AIR # 0 0 0 0 4 1
CONDITIONING. PERMIT VALIDATION
I HEREBY• C TI THAT I AM NOT ACT ,IN VIOLATION OF 2•o o 13.00
CHAPTER 9, DIVIS 3, OF THE BUSINESS PR SSIONAL CODE.
OF THE STATE ORNI 0 0 0 13.0 0 um
SIGNATURE 14
r
OF PERM ITTE'E - L
DISTRICT N0. -J PROCESSED 0 2 1"6-79'U_7 9
76ASGAE-C6 les 0/75 - AppLIC ION FORA IT
4., .. -HEATING - VENTILATING - AIR CONDITIONING
3
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING �rJ. ��/. �/ //m0 / e
(PRINT OR TYPE ONLY) ADDRESS (p
LOCALITY Temple e �•l
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
f
CROSS ST.
ABSORPTION UNIT, BTU
OWNER n e
AIR HANDLING UNIT,-CFM MAIL �y
ADDRESS la& , L(J) I mQ/")
BOILER, BTU CITY ,,,, le C� TEL. NO.
COMPRESSOR,
BTU �D ��
CONTRACTOR J dondl r,V5 -
VENTILATION SYSTEM ADDRESS: FJ - a K ` G
EVAPORATIVE.COO ER CI:TY�ern le CSTATE �/�Q f�' TEL. NO, ag�lfFURNAO
/ FLOORCE: FAU BTU R VI Y LICENSE NO. A 48 �/ O CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. [,LOP ZONE ESSED BY
WALL
�p ( E;
C.3
(/ C
INSPECTION R CORD
y
z_
rTER
heck fee 25%of above. +� �
PERMIT•ISSUING FEE $ �
TOTAL FEE
.CHECK APPLICANT
ADDRESS
TEL.NO.
EREBY AGKNOW LEDGE THAT I HAVE READ THIS APPLIC]PERMIT
ATE THAT TME ABOVE IS CORRECT AND AGREE TO CALL ORDINANCES AND LAWS REGUI.ATIN6 HEATING,,AIR CONDITIONING.
HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLAPPROVALS DATE NSPE OR'S SIGNATURE
PTER 9, DIVISION OF THE SINE•SS AND PROF SSOF THE STATEOF IFOR!IA ROUGHTUREERMITTEE FINAL
PLAN CHECK VALIDAT N VALIDATION cK. M.o. CASH
CK. M.O. CASH
28
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