HomeMy Public PortalAbout5444 BALDWIN AVE_Mechanical__ (2) 76A364c+(ce818e)-4n7 APPLICATION FORPERMIT
HEATING - VENTILATING - AIR CONDITIONING
I
BUILDING AND SAFETY DIVISION ry
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY 01
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT.BTU
OWNER
AIR HANDLING UNIT,CFM MAIL -J
ADDRESS O�,dLJ
BOILER.BTU CIT` / TEL.NO.
COMPRESSOR,BTU �U CONTRACT( .L.1 -A/ � �,
VENTILATION SYSTEM ADDRESS
--LQ I� - -
EVAPORATIVE COOLER CITY Q �,w� - If
TEL.NO
�7 7-/ 6
FURNACE. F A U GRAY T, _ STATE fjL+^� s LIC.
FLOOR BTU/ZV LICENSE NO. J JCLASS
HEATER SUSPENDED____ _ DISTRICT No. 011P I.NJe P o 5SED BY 0
WALL �, J "Q ( V
G9
INSPECTIOLu
N RECOR
V
N
7 /O- 2 z
Plan check fee 25% of above.
PERMIT ISSUING FEE > rr
TOTAL FEE
PLAN CHECK APPL)CANT
NAME
ADDRESS
CITY TEL.NO,
IHEREBY ACKNOWLEDGE THAI I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL --
ORDINANCES AND LAWS REGULATING HEATING. VENTILATING, AIR
CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECT T E
CHAPTER 9, 1(ISION 3, OF THE INFSS PROFESSIONAL CODE
OF THE STATE CALIFOR ROUGH 4
SIGNATURE FINAL
OF PERM ITT
PLAN CHECK VALIDATION CK. m0 CASH PERMIT VALIQATI CK M • • AZNO 0
• • • 27+005
04,23-79