HomeMy Public PortalAbout4836 DOREEN AVE_Mechanical__ JGN➢BAE - CEB!�9B-9/]6- AP�N FORRMIT •`
HEATING VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION ..
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS' �J
LOCALITY
No. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST p
CROSS ST. F-u Ja
ABSORPTION UNIT, BTU=
OWNER
AIR HANDLING UNIT, CFMMAIL
ADDRESS
BOILER, BTUCITY�� CC-! , NO, r
L C
COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY 366
FURNACE: FAUGRAVITY STATE LIC. VV -
FLOOR BTU =- LICENSE NO. 2 CLASS
• HEATER: SUSPE DSO S1N1T DISTRICT NO. GRova ZONE PRocE o Br
WALK Z
INSPECT]ONRE CO RD
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Plan check fee 25%D of above.
PERMIT ISSUING FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS a � i
CITY TEL.N
I HEREBY A N OWLEDGE 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.
I HEREBY T""
'NOT A[TING IN'VI ATION' APPROVALS' DATE INSPECTOR'S SIGNATUR E..
OF CHAPTER 9, OIVI51 F X r 51NE55 PROF ZONAL - �!
CODE OF THE STATE I ROUGH V ,
G
I
SNATURE -
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. YOSH .PERMIT VALIDATION: CR.' M.O' CASH '
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