HomeMy Public PortalAbout5710 ROWLAND AVE_Mechanical__ 76A364c ( APPLICATION FOR PERA7IT
HEA'7I1MG - VENTILATING - AIR CONDITIONING
u
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN "'LD'IG _
(PRINT OR TYPE ONLY) ADDRESS (� i L
LOCALITY
NO. TYPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST. �
ABSORPTION UNIT.BTU
OWNER
AIR HANDLING UNIT,CFM MAIL w�
ADDRESSlA�I �lU
BOILER,BTU CITY V TEL.NO.
i V�
COMPRESSOR,BTU CONTRACTOR `G
VENTILATION SYSTEM ADDRESS �i d
AV
EVAPORATIVE COOLER CITY TEL.NO.
FLOOR BTU
FAU !pI
STATE /� ` LIC.
LICENSE NO. "J!%/, S/vis CLASS -� Q
HEATER: SUSPENDED UNIT- DISTRICTNO. GROUP ZONE PROC SED BY 0
WALL 0 7 I
` / a
O
INSPECTION RECORD U
W
H
Plan check fee 25%of above.
PERMIT ISSUING FEE$ 17 a
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
1 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. VENTILATING, AIR
CONDITIONING.
1 HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION OF APPROVALS DATE INSPECTOR'S SIGNATURE
CHAPTER 9, DIVISION 3, OF TH BUSINESS AND PROFESSIONAL COD
OF THE STATE OF CALIF NIA ROUGH
SIGNATURE ak/ I , FINAL
OF PERMITTEE
PLAN CHECK VALIDATION cK. M.o. CASI(�P Ri�t'IT`VA (DATION CK. M.O. CASH
0 No
0 0 0 Q.
CA
�1 0 pD
�1✓ '� (v -.1 O O CTI
CH