HomeMy Public PortalAbout5331-5333 SANTA ANITA AVE_Mechanical__ 76A384E-CE{1{8-975 APPLIC ION FOR PE IT
HEATING = VENTILATING ' AIR CONDITIONING ,
3 3
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS �' /✓
NO. TYPEOFAPPLIANCEOREQUIPMENT FEE LOCALITY
NEAREST
CROSS ST. /LGey
ABSORPTION UNIT, BTU
OWNER Q
AIR.-HANDLING UNIT, CFM MAIL it
ADDRESS
BOILER, BTU CITY TEL. NO.
COMPRESSOR, BTU :Z �GN �^
CONTRACTOR ;
VENTILATION SYSTEM ADDRESS
7
EVAPORATIVE COOLER CITY �J k TEL. N0-M?7-fa73.!X
FURNACE: FAU_GR VITY STATE'
�Z FLOOR BTU OteToO LICENSE NO..;2br?j43 CLASS 7-
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP (�//�i/�ZONE PRO SSED BY },
WALL �r+ �, ) C
Vii. ♦' V
tose4g cc
INSPECTION.RECORD 'C2
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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 ORDINANCESAND LAWS REGULATING HEATING, VENTI-
LATING,AIR CONDITIONING.
1 HEREBY CERT I AM NOT ACTING IN VIOLATION APPROVALS DATE r INS PECTOR'S SIG�rA RE
OF CHAPTER 9, D ION 3., THE BUSINESS NO PROFESS.IONAL / rrA.
CODE OF THE ST E CALI ORNIA. ROUGH -,p;_� •' ,r/ ,� ,,,j•,,•��'�
SIGNATURE - �®`e•- =. ++,.��-�
OF PERMITTE FINAL'
PERMIT VALIDAT.IO'NK.. M.O.. CASH
PLAN CHECK VALIDATION CK. M.O. CASH r
4:3'21TAUG ' '3 4:1.,® 3 �.5. (� ! '
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