HomeMy Public PortalAbout9549 BLACKLEY ST_Mechanical__ 76A364E-,CEBISB-9/75 APPLICATION FOR PERMIT
HEATING VENTILATING AIR CONDITIONING' �1
BUILDING AN S FETY DIVISION
FOR APPLICANT TO FILL IN . BUILDING
(PRINT OR TYPE ONLY) ADDRESS 9549 E. BLACKLEY ST.
' -• LOCALITY � •
NO. TY
T.F. CITY
P.EOFAPPLIANCEOR'EQUIPMENT FEE NEAREST
CROSS ST. t
ABSORPTION'UNIT, BTU a
OWNER Am
AIR.HANDL•ING UNIT, CFM MAIL ^��
ADDRESS SANE
7 BOILER, BTU CITY r�wa r TEL."NO. 2OC_38G
1 COMPRESSOR, BT.0 3 HP' 7 50 CONTRA�lC1�TlOiiCCR�,r• 1'TT� HCC OJ U
VE,N'TI"CATION SYSTEM ADDRESS
2034 N. PECK '
EVAPORATIVE COOLER ('�qq—� CITY TEL. NO. 579-7982
1
FLOORFURNABTU
FAU BTU R a60 7 50 LICENSE NO. CLASS _
HEATER: SUSPENDED UNIT_ DISTRICT N0, GROUP ZONE PRO SSED BY
oma.
WALL v
0
INSPECTION RECORD w
c.
CIO
_ Z
Plan check fee 25% of above.
PERMIT ISSUING FEE $ 4 50
TOTAL FEE 19 50
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING. .
1 HEREBY, CERTIFY THAT I AM�JTING 'IN VIOLATION APPROVALS DATE INT S
OF CHAPTER 9, DIVISION 3, OF THE BAND PROFESSIONA ROUGH
CODE OF THE STATE OF C LIFOR
SIGNATURE NAL
OF PERMITTEE• /' �
PLAN CHECK VALIDATI CK. M.O. CASH PERMIT VALIDATION Yr.{S/- M.0. CASH
9.5 0
p'3 .9 AUG , '.41 10 1 _
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t _v6D 1-