HomeMy Public PortalAbout10670 LORA ST_Mechanical__ 7BA.3B6E-CrE:iBB.9i'B APPLICATION FOR PERMIT
H-EATIN.G,- VENTILATING - AIR. CONOITIONIN.G
' BUILDING AND'SAFETY DIYISION-
FOR APPLICANT TO FILL IN FBUILDING;:.
(PRINT OR TYPE ONLY) ESS UtO.� V •.� i �� v��
LITY, �•
NO. TYPE OF APPLIANCE OR EQUIRMENT FEE ESTS ST.
a+
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT,-CFM MAIL
ADDRESS U �! C-,
BOILER, BTU CI
COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS 's--'w
EVAPORATIVE COOLER CITY TEL. NO. I( '
FURNACE: FAU_GRAVITY. STATE .. LIC. YY�c
FLOOR BTU LICENSE NO. ''j CLASS S�
HEATER: SUSPENDED UNIT_ DISTR•I.CT.NO. GROUP ZONE ESSED BY
WALL r
ILI
i INSPECTION RECORD
10 .
Cn
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 THIS APPLICATION
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 NOT ACTING IN VIOLATION APPROVALS - DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISI i OF THE BUSINESS AND PROFESSIONAL-
"' O
ROFESSIONAL• - -
CODE OF THE STATE 0 CAL. ORNIA ROUGH
SIGNATUREl !FINAL
OF PERMITTEE'
PERMIT VALIDATION
PLAN CHECK VALIDATION• K. M.O. 'CASH
yam• M.O: CASH
2.` �'`-