HomeMy Public PortalAbout5542 ALESSANDRO AVE_Mechanical__ %ki)P 10 oit AI.A-rioN CE - 8176A364C 8 (2-80) APPLICATION FOR PERMIT
I hrel ITIiiP i� 'I 11 , of consent to Self
insure or a atjon Insurance,or HEATING-VENTILATING-AIR CONDITIONING
❑ Certified :on', 1:- Ill 7:';��w COUNTY OF 1_09;R/J�NGEL S �:,,Jl LDING AND SAFETY
0 ertified1,, a -0 i",, y building inspection
e I)ar in e n t. FOR APPLICANT TO FILL INV ADL
Date (PRINT OR TYPE ONLY)
ADL
LOCALIT-r—,,
1( \11 1.�f,KS' NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
"r'1; NEAREST
C OSS�
(This section need te r
CROSS ST a.
I' UNIT, BTU
the work involved ABSORPTION 0
by the pe unit is fok. ii'w':!' Llf)llikr, (5I100) or less.) DISTRICT 0
I celtify that it, fhc p th, �\c'rk for which this iAIR HANDLING UN"
permit is issued. f sl1 �': !) .i "ile! �ui, person In any manner
so as to he(,oim- ijhj < V.k)0k;',s' ('omrLnI;a11on Laws, 1BOILER, BTU
it UJI
Date__ \1)1'1; ere) [3-
COMPRESSOR, BTI' Cn
NOTICL Ti> l—I I 1i, j!t,i niikirig this Certificate ofVENTILATION SYS z
Exemption, -W i ',e� pito the Workers'
Coinpeiisati,)n pr J,I ' th r ti you must forth-
\%ith coulpl% tl);s Permit shall he EVAPORATIVE COOLER
deemed ieNol,.od,
FURNACE: FAU_ GRAVITY
y YA I? %T11 ON FLOOR:_ BTU
I herebN affirm th it I Lir lit under provisions of Chapter HEATER: SUSPENDED UNIT
9 (commencine N00: S_i)orl "0W)'t of I)i�iion 3 of the Busi- WALL
ness and frit ey:!'M' i 1;. n, is in full force and
effect.
License
Contractor 0
—7
a n, ?,,nw, w� !�l ii. r requirements as I am a
icenseJ Ltichir 3 star 1 professional engineer Plan check fee 25% of above.
acting III IIIN L,iI)SCit_V (Section 7051, Bus-
iness an,] i'ode), PERMIT ISSUING FEE .,
I.ic.or Rcg. IN,, Date TOTAL FEE
i()M F 0�_ Lli 1 DFC1 ARATION PLAN
I hereby aff;1111 NAME:
Lic,mso 7031.$. Busi-
ness and ADDRP'
\,.,ork and the
s 1- I:i:", CITY
t LI, I.) %;de (Section
7044, l'li-
Ln
1. a, o _,:Iusivej\ roniracting OWNE
w0l) Ir ns J to Lc'n'tluct the project MAIL
-
(Se ctiou -;0 =of i Ens Code),
ADDRESS 5:T J116
CITY_r_� 'Y7
'4
41
for the I, i r -,Jhich tlli,., perillit ill CONTRAC
1700
ADDRESS
1 700 'r
CITY
41
1 OC
7
1 7. OC
STATE C. 0808_8C
LICENSE NO. ',LASS
q11' RT'X"Fl?'T' I,OR r'<111 A N .i T'OF?V T AN(;[ N(;l
r