HomeMy Public PortalAbout5325 1/2 SANTA ANITA AVE_Mechanical__ G4-
7GA364M CEGIGB-9/75 APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DAA"'
iGIA 'r
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY �t
NO. TYPE OFAPPLIANCE'OR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU ,S^��n(� f CITY �w►� TEL. NO. 44j j,- Qr
v�
COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL. NO.
FURNACE: FAU_GRAVITY STATE / / LIC.' }'7
FLOOR BTU LICENSE NO. (O � c7 CLASS
DISTRICT NO. GRO ZONE OCES BY
DIST
HEATER: SUSPENDED UNIT_ O
WALL v
C
INSPECTION RECOR
w
a
Plan check fee 25%of above.
PERMIT ISSUING FEE $
TOTAL FEE 7
PLAN CHECK APPLICANT —� V
NAME 5 l0
ADDRESS
CITY TEL.NO.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND I,AWS REGULATING HEATING, VENTI-
LATING,AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPEC 'S SIG TUBE
OF CHAPTER 9, DIVISION 3, OF THE BUSINESS AND PROFESSIONAL
CODE OF THE STATE OF CALIF O A. ,ROUGH Crs. �il"�Ajbr�
SIGNATURE
OF PERMITTEE ' � FINAL
PLAN CHECK VALIDATION PERMIT VALIDATION cK. M.O. CASH-
CK. M.O. CASH
02 4 NOGT 29 4.1 0 1. 5.7 5 &9b
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