HomeMy Public PortalAbout5118 MCCLINTOCK AVE_Mechanical__ 76A3G4e-GkBiBEI-9/7s AP ICATION FO ERMIT
HEATING - VENTILATING IR' CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN- BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALIT
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEARES
CROSS ST.
ABSORPTION UNIT, BTU
OWN _
AIR HANDLING UNIT, CFM MAIL
A D DRESS
BOILER, BTU CITY TEL. N
• c I COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS ;,y,
EVAPORATIVE COOLER CITY TEL. NO.
FURNACE: FAU_GRAVITY STATE LIC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO.. GROUP NE PR ESSED BY �
WALL � I CD
r— I v
INSPECTION RECORD
a
ti
Z
Plan check fee 25%of above.
PERMIT ISSUING FEE $
TOTAL FEE D
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY NNKEL.NO.
I HEREBY ACKNOWLEDGE THAT I HAVE REA THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE' TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI- -
LATINS,AIR CONDITIONING. '
I° HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER S, TON 3, OF THE BUSINESS AND PROFESS .NAL
CODE OF THE S STATE
E DLIFOR NIA. ROUGH 3�•
SIGNATURE �v
OF PERMITT C FINAL
PLAN CHECK VALIDATIONCK. M.O. CASH PERMIT VALIDATION CK.. M.O. CASH
I S -4-`�ft-P-..14 4..1..o 9.0'0 49