HomeMy Public PortalAbout5335 SANTA ANITA AVE_Mechanical__ 7GA364E C281 BIB 9/75 APPLI ION FOR PER
HEATING - VEN ATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN FRE
G
(PRINT OR TYPE ONLY)
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No. TYPE OFAPPLIANCEOR EQUIPMENT FEE
.
ABSORPTION UNIT, BTU
/''RO.!T e V e,o
AIR HANDLING UNIT, CFM .BOILER, BTU TEL. NO.
COMPRESSOR, BTU � TOR
VENTILATION SYSTEM ADDRESS
O &x
EVAPORATIVE COOLER CITY � jX����TEL. NO.3�/T
FURNACE: FAU_GR VITY STATE LIC.
FLOOR BTU OdD4TD LICENSE NO. CLASS G"-..
ayr
HEATER: SUSPENDED UNIT_ DISTRICT N0. GROUP NE CEBBED BY C7
WALL v
INSPECTION RECORD
a
y
Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE •
PLAN CHECK APPLICANT
NAME I
ADDRESS
CITY TEL.NO.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO,C'OMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING,AIR CONDITIONING.
1 HEREBY CERTIF HAT AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATOR
1 OF CHAPTER 9, DIV ON 3, OF HE NOT
AND PROFESSIONAL
CODE OF THE STA CALIF NIA. ROUGH
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. cnsH
4 3 1410MM 3 41 ,0 1 9.50 A96
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