HomeMy Public PortalAbout5837-5839 TEMPLE CITY BLVD_Mechanical__ FGA986L;_R QaB18B-9/75 APPLICATION FOR PER
HEATING - VENTILATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(PRINT OR TYPE ONLY) ADDRESS
LOCALITY
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER
AIR HANDLING UNIT, CFM MAIL
ADDRES
BOILER, BTU CITY EL. NO.
COMPRES'q R, B U 16 Dd
CONTRACTOR
VENTILATION SYSTEM ADDRESS 3�
EVAPORATIVE COOLER CITY EL. NO.
FURNACE: FAU_GRAVITY STATEC.
FLOOR BTU O LICENSE NO. CLASscy
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE PROC BED BY
Y WALL �-
INSPECTION RECORD
W
d
Z_
Plan check fee 25% of above.
PERMIT ISSUING FEE $ d D
TOTAL FEE
PLAN 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
A WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING,AIR CONDITIONING.
I HEREBY CERT TH AM NOT ACTING IN VIOLATION APPROVALS DATE INSPECTOR'S SIGNATURE
OF CHAPTER 9, DI S10 OF E USINESS AND PROFESSIONAL ,
CODE OF THE STA E OF R 1 ROUGH
SIGNATURE
OF PERMITTE FINAL
PLAN CHE VALIDATION CK. M.Op _ 4ASpo PERMIT VALIDATION CK. M.O. CASH
tO 0 0 0 0
N o 0 o O,
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