HomeMy Public PortalAbout10243 FREER ST_Mechanical__ 'ew_e•a cg8188-9/75 ' APPLICATION FbR`P,,ERMIT
HEATING'- VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY'D,IVISION
--FOR APPLICANT TO FILL IN BUILDING �'a �.
(PRINT OR,TYPE ONLY) ADDRESS' Q, ,7c�' e`
LOCALITY
ANO TYPE OFAPPLIANCEOR EQUI,PMENT 4 FEE NEAREST ,
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ABSORPTION UPT, BTU
OWNER _ -
AIR,HANDLING UNIT, CFM
MAIL' -
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BQ,ILER, BTU '- _
CITY • : TEL"NO 6 '
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COMPRESSOR, BTU'xf,
CONTRACTO ,
VENTILATION SYSTEM, ADDRESS,.
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EVA P0RATIV,E COOLER CITY, TEL
' FURNACE -`FAUGRAVITY STATE LIC-
q FLOOR 'BTU F LICENSE=NO.,;, CLASS'L_
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HEATER SUSPENDED UNIT_ DISTRICT No UP ,ZONE EsSED B,r
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INSPECTION RECORD W
Plan check fee 25% of above
PERMIT ISSUING F'EE S.
TOTAL.FEE
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PLAN CHECK APPLICANT
NAME ' l
ADDRESS'
CIT ` TEL NO�LJ
` •HEREiY •ACKNOWLEDGETHAT I HAVE READ YTHIS APPLICATION' ' ,r'-..'�,. t•'. ` ° - f -
AND STATE'THAT,THE ABOVE 15 CORRECT AND AGREE T,0 COMPLY - _
WITH ALLORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATINW, AIR CONDITIONING
_ APPROVAL`S,! DATE INSPECTOR'S SIGNATURE-
I HEREBY CERTIFY THAT I AM NOT ACTING,;IN'�VIOLAT+ION I',
OF CHAPTER"9, DIVISION 3, THE �1 S AND' �OFEyc,��IONAL ,^ N
CODE OF THE,STATE OF C 6FO�R/NIg/-��/ o ��._� ROUGH
SIGNATUREFINAL,
OF
OF PERMITTEE dZ FINAL
PLAN CCKM O CASH r
HECK VALIDATION PERMIT'VA�LMATION cK� ` M o ; „cASH=,
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