HomeMy Public PortalAbout5319-5321 SANTA ANITA AVE_Mechanical__ 7BAasar.-ceB,se-°i'S APP•LI ZA N,FOR PE IT
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
7FOR APPLICANT TO FILL IN BUILDING s
(PRINT OR-TYPE ONLY) ADDRESS /✓l�/� /�-vr�
OFAPPLIANCEOR EQUIPMENT FEE LOCALITY M p r CIY"
NEAREST
• CROSS ST.
ABSORPTION UNIT, STU
OWNER
AIR.-HANDLING UNIT, CFM- MAIL
ADDRESS
BOILER, BTU CITY TEL: NO.
COMPRESSOR, BTU � 'r0/� `�
CONTRACTOR �-
VENTILATION SYSTEM ADDRESS R E F6x
EVAPORATIVE COOLER CITY d� �� TEL. NO.337-,G./
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7 FURNACE: FAU_GR VIT•Y STATE •LIC.
FLOOR BTU O105
LICENSE NO. -CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. . . GROUP I QIE C PROC SSED BY
WALL
67,0
INSPECTION-RECOR
4
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Z
Plan check fee 25%,of above. .
PERMIT ISSUING'FEE $
TOTAL FEE
PI.AN 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. .
1 HEREBY CERTIF DATE INSPECTOR'S SIG TURE
AT AM NOT ACTING IN VIOLATION APPROVALS ,-•_,1 •y�,i•
OF.CHAPTER 9, DIV ON 3, OF HE BUSINESS AND PROFESSIONAL r' •.•S•�
CODE OF THE STA 0 CALIFO NIA. ROUGH
SI.GNAT,URE FINAL'
OF PERMITTEE _
PLAN CHECK' VALIDATION. CK. M.O. cnsH PERM'1•T'VA-L'IDATION cK, M.o. CASH
4.3
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