HomeMy Public PortalAbout5012 FIESTA AVE_Mechanical__ 7GA364E C698188 9/75 APPLICATION FOR PERMIT
HEATING - 'VENTILATING - AIR CONDITIONING
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BUILDING AND SAFETYDIVISION
FOR APPLICANT TO FILL IN BUILDINGADDRESS ~ - e �!('
(PRINT OR TYPE ONLY)
LOCALITY `l
NO TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST
ABSORPTION UNIT BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS (� 2-
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BOILER BTU CITY e C,1TEL NO
COMPRESSOR BTU CONTRACT R _
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VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY _ TEL N23 L
FURNACE FAU GRAVITY STATE LIC
FLOOR BTU LICENSE NO CLASS C Zv
HEATER SUSPENDED UNIT_ DISTRICT NO GROUP ZONE PROCESSED BY
WALL �-
INSPECTION RECORD r OO
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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 TH]NE.N CATION
AND STATE THAT THE ABOVE IS CORRECT AND AGRLY
WITH ALL ORDINANCES AND LAWS REGULATING HI
LATING AIR CONDITIONING
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I HEREBY CERTIFY THAT I AM NOT ACTINGON APPROVALS DATE INSPECTOR S SIGNATURE
OF CHAPTER 9 DVISI F THE BUSINESS ANDALCODE OF THE STATE F A 0 NIAROUGHSIGNATUf4E
OF PERMITTEE cFINAL 2_77?
LJIMII PLAN CHECK VALIDATI CK M o CASH PERMIT VALIDATION M o cnsH
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