HomeMy Public PortalAbout6435 ENCINITA AVE_Mechanical__ 7GA364E (CE-61BAT 11/76 APPLICATION FOR PERMIT
NEAT VENTILATING - AIR CONDITIONING
UNTY OFt�
Df;;D'ARTMENT OF40U ENGINEER
BUILDING AND SAF DIVISION
FOR APPLICANT TO FILL IN : BUILDING -
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT'
FEE NEAREST
CROSS ST. d
ABSORPTION UNIT.BTU - '
OWNER
AIR HANDLING UNIT.CFMMAIL
ADDRESS
4
BOILER,BTU CITY - TEL.NO,
COMPRESSOR BTU CONTRACTO
VENTILATION SYSTEM ADDRESS �,�J�JOe-
EVAPORATIVE COOLER �, G �STATE / 17 �/.J9�
FURNACE: FAU -6FLOOR BTU R VI V LICENSE NO. ��-y (p fp CLASS"' ,-:3z
HEATER: 5USPEN D —UNIT— yT DISTRICTNO. GROUP zONE OCESSED BY
WALL U
_S O S -'
INSPECTION RECORD 6
0
V
O
Plait check fee 25% of above. 11—
PERMIT
PERMIT ISSUING FEE$ V a
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY 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', VENTILATING. AIR
CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INS PECTOR'SSIGNATURE
CHAPTER 9, DIVISION 3, OF THE BUSINESS ANDflOFE5510 NIAL CODE ROUGH -
OF THE STATE OF CALIFORNIA.
SIGNATURE FINAL
OF PE RM ITTE
PLAN CHECK VALIDATION CK. M.O. CASH . PERMIT VALIDATION ,�— .o. - CASH.
Vkf®RE EFZS COMPENSATION
s_. ;d �yAg 7 OCT 4 ,1 D 12.0 0 Ass
POLICY HOLDER: �� 3 - -. -- . .
POLICY NUMBER