HomeMy Public PortalAbout10663 LORA ST_Mechanical__ 76li964E-CQ818H-.9/75 APPLI CATION ,• .
IiEA'T�ING - VENTILATING - AIR• CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS G• 3' .
LOCALITY "tee/'►'1 �� y� .
No. TYPE OF APPLIANCE OR EQUIPMENT FE'E _'+'NEAREST ,
CROSS ST.
ABSORPTION UNIT, BTU
OWNER1 S'C
AIR HANDLING UNIT, CFM MAIL
ADDRESS,•'• d-&. 1p 3 L.O `
BOILER, BTU may: 0-tr-k: �J CITY TEL.`NO.
COMPRESSOR; BTU CONTRACTOR
7' Ga /'S. C�
VIENTILATION SYSTEM ADDRESS a/yJj
EVAPORATIVE COOLER ' CIT•Y �• / 4- TEL. NO. S— /L-/S^
FURNACE: FAU_GRAVITY STATEG LIC.
FLOOR BTU LICENSE NO. 3 l F6 �O CLASS C
HEATER: .SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE PROCE sE BY
WALL d
O
INSPECTION RECO I.O.
C/7
Plaa check fee 25%of above.`
PERMIT ISSUING FEE $
_TOTAL FEE
PLAN }CH,ECK APPLICANT '
NAME W GSI- kms' �G S
ADDRESS` Ga.��,�p
CITY �• / li? TEL.NO /"L%�.
I HEREBY'AC KNOW LED GE THAT I HAVE READ THIS'APPLI CATION';. '
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY '
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI
LATING,AIR CONDITIONING.
' I HEREBY CERTIFY THAT I• AM •Nb.T`ACTING' IN VIOLATION+ APPROVALS DATE - :INSPECTOR'S SIGNATURE -
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL ,• .. - ..
CODE OF THE STATE OF CALIFORNIA.- ROUGH'
SIGNATURE
OF PERMITTEE FINAL
'.C/LJ.�-Y�!�•-Q-`�•"
PLAN CHECK VALIDATION PERMIT VAL' (DATION cK. :M.o. cash
C K..' M.O.. ASH