HomeMy Public PortalAbout9437 LONGDEN AVE_Mechanical__ 7fiAI9E4K:-`9811813'9i75 `- APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDI11 J
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NO. TYPE OFAPPLIANCE OR EQUIPMENT FEE LOCALITY NEAREST
' CROSS ST.
ABSORPTION UNIT, BTU
OWNER 5 C
AIR HANDLING UNIT, CFM MAIL
ADDRESS 7
BOILER, BTU
UP
� /� CIT pm ��� TEL. NO t7785 4/7
S COMPRESSOR, BTU �C.�(000 '� CONTRACTORS CUN,a rU
VENTILATION SYSTEM ADDRESS
EVAPORATIVE CO ER CIT!la.n)et'k TEL. NO.a86-)4{g
FURNACE: FAU_GR u{TY STATE LIC. ��o
FLOOR BTU (J � LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ONE P oCESS D BY.
WALL I v
7V010 o
INSPECTION RECORDcn
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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 THISAPPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING.
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISI OF THE .US ESS AND PROFESSIONAL
CODE 6F THE STATE C LI NIA. ROUGH
SIGNATURE y�
OF PERMITTEE FINAL . Gf �� lenf0,1-,
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N c . M.D. CASH
4.1 � 19.5 0 0V8