HomeMy Public PortalAbout6234 LOMA AVE_Mechanical__ 76A364C(CIE-8188)-11/76 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
-9 j
BUILD NG AND SAFETY DIV ON T r^
FOR APPLICANT TO FILL IN BUILDING 6234 N. I Oi'1A
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY Tm= CITY
NO TYPE OF APPLIANCE OR EQUIPMENT FEE
NEAREST
CROSS ST b�^�T�yy�� T,�TT�T��T
ABSORPTION UNIT,BTU OWNER I� PRADD, rJICHAEL
AIR HANDLING UNIT,CFM MAIL
ADDRESS SAME
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BOILER,BTU - CITY TF'MPT,F CITy TEL
+NO, 286-2611
1 COMPRESSOR,BTU CONTRACTOR 1,11111i�AM HCC
VENTILATION SYSTEM ADDRESS 2034 N., PECK PD.
EVAPORATIVE COOLER CITY 5' L T 'RiR.TR*(� TEL NO -
7982
FURNACE FAU_GRAVITY STATE 1:+1a 1.1L`11L y LIC
1 FLOOR BTU 100.000 7 cio LICENSE NO L CLAS
HEATER SUSPENDED UNIT- DISTRICT NO GROUP ZONE I I POC SED BY
WALL
INSPECTION RECORD" o'
0
V
0
Plan check fee 25% of,above .
PERMIT ISSUING FEE$ 4 50 voi
TOTAL FEE 19" 50 z
PLAN CHECK APPLICANT - -
NAME
ADDRESS
- f
CITY TEL NO ,
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, VENTILATING, AIR
CONDITIONING -
I HEREBY CERTIFY THAT I AM NOT TING IN VIOLATION OF APPROVALS DATE j IN TOR S SIGN TORE
CHAPTER 9;DIVISION 3, QF THE SIN D P FESSIONAL CO
OF THE-STATE F 0,ehl I ROUGH J
SIGNATURE FINAL
OF PERMITTE
PLAN CHECK VALIDAT ON CK MO CASH PERIWIT VALIDATION CK CASH
MC; KERS COMPEN8ATION
(4E�p S 1� 2 0 n 3�.}" 9 4 -1 D
POLICY HOLDER: o r WA 05Av
POLICY NUMBER: oil g 00 Or�076-2, o5