HomeMy Public PortalAbout9130 WOOLLEY ST_Mechanical__ 76 p364 -`CE 818 - 9-71 APPLI TION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN OWNER L' �o/J/�RU ZUjL
(PRINT O� TYPE ONLY)
MAIL -7 �/
NO. TYPEOFAPPLIANCEOR EQUIPMENT FEE ADDRESS 9%30 &VQ,0&_ S
CITY/C
ABSORPTION UNIT, BTU lL� �J9•� TEL. N1.
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU STATE LIC.
LICENSE N CLASS
VENTILATION SYSTEM DISTRICT NO. GROUP J']ZONE SED BY
EVAPORATIVE COOLER
r
FURNACE: FAU_GRAVITY INSPECTION RECORD v
FLOOR BTU o:
HEATER: SUSPE T- ,nn v
WALL t � Lu
a.
• Z
Cn
Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE 3 s 00
TOTAL FEE
PLAN CHECK APPLICANT y
NAME
ADDRESS /' !/ I /
CITY 4; yEL.NO. S-1
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORD IN AND LAWS REGULATING HEATING, VENTI- APPROVALS DAT INSPEC�O 3 SIGNATURE
LATIN., AIR CON IT10 G.
ROUGH �
I HEREBY ERTIFY THAT 1 0 A NG IN VIO ION
OF CHAPTER % DIVISION 3, OF TH BU ES A P FES I NAL FINAL
CODE OF THE ATE OF ALIFOR NI
SIGNATURE ERMIT VALI TION CK. M.O. CASH
OF PERMIT
PLAN CHEC VALIDATION CK. M CASH
� ��', 1 8 7 07'3- JU 26 4 1 0 8t QA
75-". UI= 51 8-1/75
APPLICATION '-FO R PERMIT
r HEATING - VEN-TILATING - AIR CONOITIO.NIN•G
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
NEAREST
•CROSS ST. "
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY) E
MAIL
NO. TYPE&SIZE OF EQUIPMENT' FEE ADDRESS &D-
SEE BACK OF APPLICATION �•+
CITY'/ TEL. NO. /
FORCE AIR FURNACE, BTU
CONTRACT
COMPRESSOR, BTU
ADDRESS ' 7w �4A
vF
VENTILATION FAN L CITY - TEL. NO.
LIST ALL OTHERS BELOW STATE LIC.
LICENSE NO, CLASS
DISTRICT NO. GROUP I ZONE PROCES BY
9�
INSPECTION RECORD
G_
O
U
O
F-
U
W
Pian check fee. See reverse.
PE11NIIT ISSI;.ING FEJ,: S 7&V
TOT I, FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CI TY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT. AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
ROUGH
IHEREBY CERTIFY THAT 1 AM NOT ACTING IN VIOLATION
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL FINAL /!
CODE OF THE STATE OF CALIFORNIA. 7 '���C+•�-�
SIGNATURE PERMIT VAL D IO / CK. s- M.O. CASH
OF PERMITTEE
PLAN CHECK VALIDATION CK. M.O. CASH r
62Oi;AUG
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