HomeMy Public PortalAbout4914 KAUFFMAN AVE_Mechanical__ CDD 104 7-72 ,
/ APPLiCAT FOR PEROT
HEATVENTILATING - AIR C NDIT10 G
BUILDING /
_ ADDRESS
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING AND SAFETY SECTION LOCALITY
NEAREST
CROSS ST.
FOR APPLICANT TO :FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE ADDR el
ABSORPTION SYSTEM, BTU CI T ,. NO�(j
AIR HANDLING UNIT; CFMCONTRACTOR '
ADDRE
BOILER, HORSEPOWER
CIT r �J TEL. N0.
COMPRESSOR, HORSEPOWER STATE "Sir r- LIC. �f��5
LICENSE NO. CLASS t +4
VENTILATION SYSTEM DISTRICT NO. GROUP ZONE PRO SSED BY
EVAPORATIVE COOLER
FURNACE: FAU GRAVITY V
INSPECTION RECORD
FLOOR BTU
HEATER: ;SUSPEND D UN PT O
WALL U
W
O-
N
z
NEW. ADDITION— PERMIT $ 3 00
ALTER_REPAIR_ TOTAL FEE S
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL. N0.
IHEREBY ACKNOWLEDGE 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- APPROVALS DATE INSPECTOR'S SIGNATURE
LATING, AIR CONDITIONING.
I HEREBY CERTIFY AT I A NOT ACTING IN VIOLATION OF ROUGH
CHAPTER 9, DIVIS F T BUSINESS A PROFE ONAL FINAL --,3 �7
CODE OF THE ST E 0 IF I.A.
SIGNATURE
OF PERMITT - 4-
PLAN CHECK LIDATION
PERMIT bALIDATI®� . 21 4-1. L 8'.o:U
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE