HomeMy Public PortalAbout5837-5839TEMPLE CITY BLVD_Mechanical (2) 7GA364M aE8186-9/79 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING LJ
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING p
(PRINT OR TYPE ONLY) ADDRESS �J
LOCALITY
NO. TYPEOFAPPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST. '
ABSORPTION UNIT, BTU
OWNER IL! /vel-
AIR HANDLING.UNIT, CFM MAIL
ADDRESS'
BOILER, BTU CITY LipTEL. NO.
COMPRESSOR, BTU
CONTRACTOR .--
VENTILATION SYSTEM ADDRESS .630
EVAPORATIVE CO ER CITY TEL. NO.
FUF(NACE: FAU_GRA Y STATE �� f CLASS -aO
FLOOR BTU LICENSE NO.
HEATER: SUSPENDED UNIT_ DISTRICT N0. GROUP ZONE PROCESSED BY °-
O
WALL �O � �� C Z• oC
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V
INSPECTION RECORD ly
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME + -
ADDRESS
Cl TY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION=
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
1 HEREBY CERTIF THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE ' INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIV ON , OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STA OFC I ROUGH r
SIGNATURE
OF PERMITTE FINAL
PLAN CHECK VALIDATION PERMIT VALIDATION cK. M.o. cases
CK. M.O. CASH
633NDEC 134:1 D 1 2.0 0 ;