HomeMy Public PortalAbout6341 SULTANA AVE_Mechanical__ 7GA384E- CB,66.-9i73• APPLICATION FOR PERMIT {�
HEATING -,VENTILATING - AIR CONDITIONING u
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BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING ' i/�
(PRINT OR TYPE ONLY) ADDRESS /�
LOCALIT
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEETNEAREST
CROSS ST.
ABSORPTION UNIT, BU
OWNER jj
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AIR HANDLING UNIT, CFM MAIL
ADDRESS
BOILER, BTU CITY 'TEL. NO.
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COMPRESSOR, BTU CONTRACTOR
VENTILATION SYSTEM ADDRESS
EVAPORATIVE COOLER CITY TEL. NO.
FURNACE: FAU_GRAVITY STATE 'LIC.
FLOOR BTU LICENSE NO. CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUPZONE CESSED BY
WALL n.
czI INSPECTION RECORD
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
TOTAL FEE 161 p O
PLAN CHECK APPLICA T
NAME
ADDRESS
Cl TY T t NO.
J HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL ORDINANCESAND LAWS REGULATING HEATING, VENTI-
LATING,AIR
ENTI-LATING,AIR CONDITIONING.
I HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE'
OF CHAPTER S, DIVISION 3,.OF THE BUSINESS AND PROFESSIONAL ��2�r w+�•
CODE OF THE STATE OF CAL RNI ROUGH J�
SIGNATURE -"
OF PERMITTEE FINAL
PLAN CHECK VALIDATION PERMIT VALIQATI cK. M.O. cases
CK. M.O. CASH
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