HomeMy Public PortalAbout9735 WOODRUFF AVE_Mechanical__ 76A366E- CE8188-978 APPLI ION FOR PE IT
HEATING - VEN LATING - AIR CONDITIONING
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN ADDRESS ,3o (�L
BUILDING �OOd (J� /r
(PRINT OR TYPE ONLY) /6L
LOCALITY
NO. TYPE OFAPPLIANCEOR EQUIPMENT FEE NEAREST
CROSS ST.
ABSORPTION UNIT, BTU
OWNER o/- f1Cjjj 1ecl:r6A1
AIR HANDLING UNIT, CFM MAIL
ADDRESS /1ij t
BOILER, BTU CITY - TEL. NO.
COMPRESSOR, BTU 7 T. S'�V CONTRACTOR
VENTILATION SYSTEM ADDRESS 6 bO
} EVAPORATIVE COOLER CITY �d �� TEL. NO. �Jj�
FURNACE: FAUGRAVITY STATE LIC.
FLOOR BTU LICENSE NO. 6^ 3 CLASS
HEATER: SUSPENDED UNIT_ DISTRICT NO. GROUP ZONE SSED BY y
WALL OC7
INSPECTION RECORD
W
CL
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Plan check fee 25% of above.
PERMIT ISSUING FEE $
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 '1
WITH ALL ORDINANCES AND LAWS REGULATING HEATING, VENTI-
LATING.AIR CONDITIONING. !� /•�--���� --�
I HEREBY CERTIFY 1 AM NOT ACTING IN VIOLATION APPROVALS / ,1,V � SAjTE �NS PECT�R'551�✓TURE
OF CHAPTER 9, DIVI N 3. OF THE BUSINESS AND P FESSIONAL if
CODE OF THE STAT OF CALIF NIA. ROUGH 3�•.! '� "r'
<Y
SIGNATURE _
OF PERMITTEE iYl7 INAL v �,J ,',�/
PLAN CHECK VALIDATION PERMIT VALIDATION cK'' (M'.o. cases
CK. M.O. CASH
�. 42i',it v c 8 4 9.50Ac.,
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