HomeMy WebLinkAbout1516MECHANICAL PERMIT (HVAC) APPLICATION
City of Hermosa Beach - Community Development Department
hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
rdinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform
iork under this permit in violation of the labor code of the State of California. I further state that I am properly licensed as required
y Section 7031.5 of the tate usis and Professional Code (or claim exemption under Section 7044).
gnature o 0
Signature of Owner (If Owner/Buil(
f...\application \mechanic 9/1/13.xlsx rev 8/2
QTY
Amount
JOB ADDRESS:
=orced-Air or Gravity -Type Furnace, Includes
Vents:
1.0 Up toa00,000 B.T.U.
Z. Over 100,000 B.T.U.
$43
$43
I
SLi3
1`5 lb PP �t �
1�
JOB DESCRIPTION:
:Icor Furnace, Including Vent
$55
t -cvraitoz, ands 4401-41.
-leater-Suspended, Recessed Wall or Floor
Vlounted
$43
s, vuv,
PROPERTY OWNER(S) NAME:
3as Piping System(Enter No. Outlets):
3. 1-5 Outlets (Inclusive), Totall Fee
). 6 or More Outlets (Per Outlet)
$33
$7
l I'
�d 4
ADDRESS:
appliance Vent Only
$33
D
3oiler/Compressor:
3. Up to 3 HP or 5000,001 to 1, 000,000 BTU
). 3 to 15 HP or 100,001 to 500,000 BTU
$43
_
115163>
CITY, STATE, ZIP:
$43
.
absorption System:
L. 15 to 30 HP or 500,001 to 1,000,000 BTU
Z. 30 to 50 HP or 1,000,001 to 1,750,000 BTU
3. Over 50 HP or Over 1,750,000 BTU
$43
Cc- f
,moj� I (A lb
PHONE:
3i0 ` f `f W13
$99
$99
MECHANICAL CONTRACTOR:
?<r P[J,5 (1ip.-1 ,'
air Handling Unit/Air conditioner (Including Ducts)
1. Under 10,000 C.F.M.
?. Over 10,000 C.F.M
$55
$55
EMAIL. ADDRESS:
140,Gi 1-pliN S —14vak. Ce,,^
:vaporative Cooler (Non -Portable)
$43
/ent Fan/Single Duct
$33
ADDRESS:
goZ.() j L°M?On Ak.+ S,.(t,;
vlechanical Vent
$33
Mechanical Suppression System and Exhaust Hood
$33
tepair, Alteration, Addition to Each Heating
\ppliance, Refrigerator Unit, Comfort Cooling Unit
)r System (Includes Controls)
$43
CITY, STATE, ZIP:
G(GOP (L (A- cIJ?o t
\ny Equipment Regulated but not Included Above
Includes Factory Fireplace)
$111
PHONE:
gI g 1- 1171
Iliscellaneous
$33
BUSINESS LICEN" MO:
1131103 5
supplemental Permit Fee
$17
ssuance Fee
$60
STATE LICENSE NO:
954505
"OTAL FEE
'PLEASE CONTACT THE PUBLIC WORKS DEPARTMENT AT (310) 318-0214 IF
TYPE OF BUILDING:511 L ` 4..1. -
NO. OF STORIES: I
NO. OF METERS: (d v, 4 M2
NO. OF FAMILIES: `
VORK IS GOING TO BE DONE IN THE PUBLIC RIGHT OF WAY (SIDEWALK OR STREET.)
DATE ISSUED: i o(t.�
l
ISSUED
BY: N_
PERMIT NO: " 13_ bb13g
hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
rdinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform
iork under this permit in violation of the labor code of the State of California. I further state that I am properly licensed as required
y Section 7031.5 of the tate usis and Professional Code (or claim exemption under Section 7044).
gnature o 0
Signature of Owner (If Owner/Buil(
f...\application \mechanic 9/1/13.xlsx rev 8/2