HomeMy Public PortalAbout5336 ROSEMEAD BLVD_Mechanical__ 76A364E- CE818B -9/75 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING +�
(PRINT OR TYPE ONLY) ADDRESS .J.!_ (O �J L
LOCALITY
NO. TYPE OF APPLIANCEOR'EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU -_ OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRESS 14 /L7IFF--
BOILER, BTU CITY TEL. NO. �
COMPRESSOR, BTU71 o CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL. NO. Z7� .
FURNACE: FAU GRAY4, Y STATE .q LIC. P ,
FLOOR-BTU 7 LICENSE NO. !, �7'� CLASS C,
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE I PRO ESSED BY
_ d
WALL Jt 1 ���yfjy� v
V �
INSPECTION RECO
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Z
Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE
PLAN CHECK APPLICANT
NAME
.ADDRESS
CITY TEL.NO.
9
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY l <""
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING, AIR CONDITIONING. �w
HEREBY CERTIFY THAT I AM OT ACTING IN VIOLATION APPROVA S/) :✓�/� DATE I,af INSPECTOR'S SIGNATURE
OF CHAPTER 9, DIVISION 3, OF TH SI NESS AND PROFESSIONAL ROUGH
CODE OF THE STATE OF O A
SIGNATURE FINAL
OF PERMITTEE _
PLAN CHECK VA ATIONPER:IT�Ll DATION cK. M o. CASH
CK. M,O. CASH 9'9:04"JUIT 14
/