HomeMy Public PortalAbout5500 BALDWIN AVE_Mechanical__ 76A364E - CE818E6-9/75 APPLICATION FOR PERMIT
r HEATING - VENTILATING - AIR CONDITIONING
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BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING 'J d
(PRINT OR TYPE ONLY) ADDRESS �r C.� ' C G,•'� / G �`7
LOCALITY
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE
NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRESS �✓�(
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU s PJc!p lJ CONTRACTOR, `
VENTILATION SYSTEM ADDRESS11PY.Y
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EVAPORATIVE COOLER CITY TEL. NO. `77
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FURNACE: FAU—GRAVITY STATEa_ �y LIC.
FLOOR BTU LICENSE NO. �*s CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE SS ED BY
WALL 'Zg Cx_CD
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INSPECTION RECORD CD
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE __�®
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION -
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
IHEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISION�'�F THE BUSINESS AND. ROFESSIO NAL -r i
CODE OF THE STATE TC r(FOR NI A. ROUGH
SIGNATURE ✓..^
OF PERMIT FINAL
PLAN CK VALIDATION PERMIT VALIDATION CK. M.O. CASH
CK, M,O, CASH
5.g 8 r."MAY 25 :3 1 9.5:d ♦ s