HomeMy Public PortalAbout5003 SERENO DR_Mechanical__ TEAU*-A"U,D /TE APPLICATION FOR PERMIT ll-��g
HEATING - VENTILATING - AIR CONDITIONING
.. BUILDI AND SAFETY DI ION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO YPE OF APPLIANCE OR EQUIPMENT FEE NEAREST
CROSS ST
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT CFM MAIL
ADDRESS
BOILER, BTU CIT EL NO
COMPRESSOR BTU O O CONTRACTO
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VENTILATION SYSTEM ADDRESS aC M
D
EVAPORATIVE COOLER CITY vZ, TEL NO
FURNACE FAU GRAVIWY STATE IC
FLOOR BTU LICENSE NO CLASS
HEATER SUSPENDED—UNIT— DISTRICT No cnouP xoxE 1!��GC7ED BY Cl
WALL
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O
INSPECTION RECORD
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N
Plan check fee 25% of above
PERMIT ISSUING FEE S
TOTAL FEE
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI
LATINO AIR CONDITIONING
IHEREBY CCR FY T I A N T ACTING IM VIlOLATION APPROVALS DATE INSPECTORS SIGNATURE
OF CHAPTER 9 0 ISI ON OF THE I SS AND PRO'?S IONAL
CODE OF THE ST E OF RNIAROUGH
SIGNATURE
OF PERMITT WV FINAL
PLAN CHE VALI ATIONCK M 0 CASH PERMIT VALIDATION K D CASH
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