HomeMy Public PortalAbout5835TEMPLE CITY BLVD_Mechanical 76A964E-C6a,SIB-9i7s APPLICATION FOR PERMIT .�
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION,
FOR APPLICANT TO FILL IN BUILDING J
(PRINT OR TYPE ONLY) ADDRESS / I!/ R� .S
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE LOCALITY �
NEAREST J
CROSS ST Q� � OL
ABSORPTION.UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU CITY e LI TEL. NO.
COMPRESSOR, BTU CONTRACTOR �-��
VENTILATION SYSTEM ADDRESS t
EVAPORATIVE COOLER CITY I TEL. NO. /
FURNACE; FAU_GRAVITY STATEIC.
FLOOR BTU LICENSE NO.,-j;:7p2 CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE Roc ED BY a-
CD
! WALL O /� C'oZ
--
INSPECTION RECORD 1w
CL.
Plan check fee 25%of above. � G ���1/G p�'�' X175%
PERMIT ISSUING.FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY ` TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION A
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENT.I-
LAYING,AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS Dl� .(INSPrEC(TOR'S SIGNATURE/
OF CHAPTER 9, DIVISIOO , OFF THE USINESS AND PROFESSIONAL ��• ��(��
CODE OF THE STATE CA RNI ROUGH
•� f
SIGNATURE I FINAL
OF PERMITTEE
PLAN CHECK OALIDATION Ice M.o. CASH PERMIT VALIDATION n`.o CASH
3 6-.7 f'clt40Y .1.8 41 12.0 0 A