HomeMy Public PortalAbout5408 ROBINHOOD AVE_Mechanical__ 78A360E- CE81:;f1,-9175 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
�BUINGDSAFETY VISION
FOR APPLICANT TO FILL IN ADDRESS Jr d g N 1p �+�
(PRINT OR TYPE ONLY) D I "
LOCALITY etA t0'
NO.,.TYPEOFAPPLIANCEOR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER �
AIR HANDLING UNIT, CFM MAIL
ADDRESS C)g n/� 6O
BOILER, BTU CITY ? � ( co 10 L'+ TEL. NO.Clq�,
COMPRESSOR, BTU Or� ` l• `
CONTRACTOR
VENTILATION SYSTEM ADDRESS �} O•r (ADY
R EVAPORATIVE COOLER CITY I e i�J2C'TOTEL. N -[ /
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FURNACE: FAU_G AVITY STATE LIC.
FLOOR BTU LICENSE NO. D CLASS lC�.
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP �OfE ESSED BY °'
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INSPECTION RECORD �Lu
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Plan check fee 25% of above. yu
PERMIT ISSUING FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
i
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 AC ING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISI 3, 0 THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE AL IF NI ROUGH
SIGNATURE �
OF PERMITTEE FINAL
PLAN CHECK VALIDATION rCK. M.O. CASH PERMIT VALIDATION CCK. M.O. CASH''
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