HomeMy Public PortalAbout8603 WORTHINGTON DR - Mechanical - 1979-09-25 76A364C
CE-818(REV.11/78)
®, APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ADDRESSG% /
(PRINT OR TYPE ONLY) _
LOCALITY n L
NO. TYPE OF APPLIANCE OR EQUIPMENT PEE' NEAREST
CROSS ST.
ABSORPTION UNIT,BTU
OWNER
AIR HANDLING UNIT,CFM MAIL ,..� wt /
ADDRESS �^Lj.✓� �c.�� 1/r� 6 Vilma
BOILER,BTU •7���
CITY / TEL.NO.
COMPRESSOR.BTU CONTRACTOR ` C
VENTILATION SYSTEM
ADDRESS
EVAPORATIVE COOLER CITY TEL.NO.
FURNACE: FAU GRAVITY STATE / LIC.
FLOOR BTU LICENSE NO. � / CLASS
HEATER: SUSPENDED UNIT_ APPROVALS DAY•E INSPECTOR'S N URE
WALL
ROUGH
FINAL 0
INSPECTION REGrORD C9
O
I=
Plan check fee 25% of above.
PERMIT ISSUING FEE$ 7 —
TOTAL FEE
PLAN CHECK APPLICANT PLAN CHECK VALIDATION
NAME r U � 7— /l l/+',
ADDRESS a2 w C f jff SIJ
CITY11Z C6 0/ TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL L 6 8 6 7 A
ORDINANCES AND LAWS REGULATING HEATING, VENTILATING, AIR
CONDITIONING. PERMIT VALIDATION # o 0 o o 4 1
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF
OF THE
ER 9, DIVIOFSIION 3. O IA - 27
BUSINESS AND PROFESSIONAL CODE o 0 2 7 Q Q
SIGNATURE
OFPERMITTEE io 0 - 27.005
DISTRICT NO. PROCESSED BY Q 9,25-79
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