HomeMy WebLinkAbout1701MECHANICAL PERMIT (HVAC) APPLICATION
City of Hermosa Beach - Community Development Department
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform
work under this permit in violation of the labor code of the State of California. I further state that I am propgrly licensed as required
by Section 7031.5 oft e State Business and Professional Code (or claim exemption under Sectio
N
ignature of Owner (If Owner/Builder)
f...\application\mechanic 9/1/13.xlsx rev 8/29/13
QTY
Amount
JOB ADDRESS:
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Forced -Air or Gravity -Type Furnace, Includes
Ducts and Vents:
1. Up to 100,000 B.T.U.
2. Over 100,000 B.T.U.
$43
$43
%
JOB DESCRIPTION: //-- •
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Floor Furnace, Including Vent
$55
Heater -Suspended, Recessed Wall or Floor
Mounted
$43
PROPERTY OWNER(S) NAME:
✓i/1rn e72-4 - je �ii-vi
Gas Piping System (Enter No. of Outlets):
a. 1-5 Outlets (Inclusive), Total Fee
b. 6 or More Outlets (Per Outlet)
$33
$7
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ADDRESS: /7 ) r-P.04'ir -/ sr
tJ`-,,P1-c54- Ie.
Appliance Vent Only
$33
Boiler/Compressor:
a. Up to 3 HP or 5000,001 to 1, 000,000 BTU
b. 3 to 15 HP or 100,001 to 500,000 BTU
$43
CITY, STATE, ZIP:
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171,40...`k
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$43
Absorption System:
1. 15 to 30 HP or 500,001 to 1,000,000 BTU
2. 30 to 50 HP or 1,000,001 to 1,750,000 BTU
3. Over 50 HP or Over 1,750,000 BTU
$43
PHONE•, q
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$99
$99
MEC NICAL CONTRACTOR:
Air Handling Unit/Air conditioner (Including Ducts)
1. Under 10,000 C.F.M.
2. Over 10,000 C.F.M
$55
$55
EMAIL ADDRESS:
Evaporative Cooler (Non -Portable)
$43
Vent Fan/Single Duct-
$33
/
ADDRESS:
Mechanical Vent -
$33
/
"
Mechanical Suppression System and Exhaust Hood
$33
Repair, Alteration, Addition to Each Heating
Appliance, Refrigerator Unit, Comfort Cooling Unit
or System (Includes Controls)
$43
CITY, STATE, ZIP:
Any Equipment Regulated but not Included Above
(Includes Factory Fireplace)
$111
PHONE:
Miscellaneous
$33
BUSINESS LICENSE NO:
Supplemental Permit Fee '
$17
Issuance Fee
$60
STATE LICENSE NO:
TOTAL FEE
*PLEASE CONTACT THE PUBLIC WORKS DEPARTMENT AT (310) 318-0214 IF
TYPE OF BUILDING:
NO. OF STORIES:
NO. OF METERS:
NO. OF FAMILIES:
WORK IS GOING TO BE DONE IN THE PUBLIC RIGHT OF WAY (SIDEWALK OR STREET.)
DATE ISSUED:
ISSUED BY:
PERMIT NO: n n
11"' Op CI 11
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform
work under this permit in violation of the labor code of the State of California. I further state that I am propgrly licensed as required
by Section 7031.5 oft e State Business and Professional Code (or claim exemption under Sectio
N
ignature of Owner (If Owner/Builder)
f...\application\mechanic 9/1/13.xlsx rev 8/29/13