HomeMy Public PortalAbout10628 BOGUE ST_Mechanical__ 76A364E - % B-9i75 _ APPLICATION FOR- PERMIT '
HEATING - VENTILATING - AIR CONDITIONING '
BUILDING AND SAFETY'DIVISION G
FOR APPLICANT TO FILL IN [NEAREST
DDRESS
(PRINT OR TYPE ONLY)
OCALITY 7 61
NO. TYPE OFAPPLIANCE OR EQUIPMENT FEE
ROSS ST.
ABSORPTION UNIT; BTU
OWNER -
AIR HANDLING UNIT, CFM MAIL
A DDRESS
BOILER, BTU CITY TEL. NO.
. SS
COMPRESSOR, BTU 4,
CONTRACTOR
VENTILATION SYSTEM ADDRESS
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EVAPORATIVE COOLER - CITY , LQI�Vante TEL. NO.,,� _,7
FURNACE: FAU GR V TY STATE !! -- A LIC.
FLOOR BTU LICENSE NO.p!(OV� ( CLASS
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HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE PR0CE s D BY CL-
WALL
WALL �.� Op
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U
• 9
INSPECTION RIE-CORK�,,�•
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Cn
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Plan check fee 25%D of above.
PERMIT ISSUING FEE $
TOTAL FEE_
PLAN CHECK APPLICANT
n
NAME
ADDRESS
CITY' TEL.NO,
I"HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION -
AND STATE THAT THE ABOVE-IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- ,
LAT ING, AIR CONDITIONING '
•I HER CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE• INSPECTOR'S SAO
OF CHAPTER 9, 01 Si 110 3, OF THE EU51 AND PROFESSIONAL
CODE OF THE STATE OFC)l FOR ROUGH ,
SIGNATURE
OF PERMIl X FINAL '
PLAN CHECK VALIDATI CK. M.O. CASH PERMIT VALIDATION ✓ CK. M.O. CASH
1 9 .y i NOV y 4'�.