HomeMy Public PortalAbout6112 SULTANA AVE_Mechanical__ TV76 A3. ,°G�818- 8-73 C
APPLICATION FOR ER
HEATING'- VENTILATING - AIR CONDITIONING
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DEPAROUNTY OF LOS TMENT OF COUNTYGELES ENG NEER BUILDING _ _ I �`,_ / AI
ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY om 6i t`i T
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NEAREST
CROSS ST. P-1 ',dJ
FOR APPLICANT TO FILL IN OWNER
(PRINT OR TYPE ONLY)
MAIL
NO. TYPE OFAPPLIANCE O_R EQUIPMENT FEE ADDRESS
CITY TEL'. NO.� ��Q 7�
ABSORPTION UNIT, BTU
CONTRACTOR V112,14/C
AIR HANDLING UNIT, CFM
/ DDRESS
BOILER, BTU CITY j2LlVm V/ TEL. NO. 7676
COMPRESSOR, BTU STATE LIC.
LICENSE NO.
VENTILATION SYSTEM DISTRICT No. _ GROUP 1 111E P SSED BY
EVAPORATIVE COOLERK� % .Q
P FURNACE: FAU GR INSPEC+TI� E
ON RCORDvv
FLOOR—BTU T�'
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HEATER: SUSPENDED UNIT_
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Plan check fee 25% of above. See reverse.
PERMIT ISSUING FEE S
TOTAL FEE a
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL.NO.
LLATING,
BY ACKNOWLEDGE THAT I'HAVE READ THIS APPLICATION
E THAT THE ABOVE IS CORRECT ANO.AGREE TO COMPLY
ORDINANCES AND LAWS REGULATING HEATING, VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE
IR GONDITI ONING. ROUGH
EBY CERTIFY THAT I AM NOTACTING IN VIOLATIONER 9, DIVISION 3, OF THBUSI E AND PROFESSIONAL FINALTHE STATE OF CALIF NI
URE PERMIT VALIDATION CK. M.O. CASH
MITTEE
PLAN CHECK VALIDATION CK. M.O. CASH
8 2 3r-NOV 14 41 U' ' 1 2.0 0 A zx6
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE