HomeMy Public PortalAbout9703 WOODRUFF AVE_Mechanical__ 7GA364C
CE-0181REV.6/78)
®s APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING ADDRESS
74c)-3
7L,
(PRINT OR TYPE ONLY) ADDRESS / / GL O'a r�.z
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE LOCALITY o/G r_• ,ev
NEAREST
CROSS ST. �r �+
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL
ADDRESS 72 �j-p- Lyc
BOILER,BTU CITY 4"' TEI!.NO.
COMPRESSOR,BTU 23/ 0O U UfJ -
CONTRACTOR J t d �
VENTILATION SYSTEM
ADDRESS [!
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU G ITYSTATE q / / LIC. A r
FLOOR BTU LICENSE NO. 44 GlJ `� CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DATE INSPECTOR'S SIGNATURE
WALL
ROUGH
FINAL z- 0
INSP CTION RECORD qj
/nrs C-C xt CZ 3 YA c Ti S
Plan check fee 25%of above. 9
PERMIT ISSUING FEE$ 7 g
TOTAL FEE Z7 o
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 23531 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION. 4 ° x ° 0 4 2
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF
CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL CODE 2 - 27,00 O O rL 7 0 O
OF THE STATE O CA PdRNIA. .•
SIGNATURE
OF IRERMITrT -� �/•�+--L • — 27,006)
DISTRICT NO. PROCESSED BY 0 &02-79
&02-79