1985, 10-30 Permit App: 00008417 InsertMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
construction.
OWNER OR 6J L4 U's„
SIGNATURE OF C
APPLICATION
DATE
7eC)
Project # 84c+7
Owner's Name Last First MI
Schweikhardt Jim
Project Address (Street Name & Number)
S. 2908 Barker
City
Greenacres
State
WA 99016
Subdivision/Plat Name
Jf P02
Assessors Parcel ft_Lot
30554 ctSC._
Block
Plat #
Applicant
Address
City
State
Zip
Phone
Business Phone
Contractor
Valley Fireplace
Address
E. 16610 Sprague - PO Box 553
City
Veradale
State
WA
Zip
99037
Phone
922-2780
Contact
License if
VALLEF 177CG
Business Phone '
Describe Work Installation of Lopi LX woodstove insert
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Wate Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
101-500M
501-1,000M
1,001-1750M
Over 1750M
Compressor
0-3HP
3-15HP
15-30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10.:.00+BTU
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
construction.
OWNER OR 6J L4 U's„
SIGNATURE OF C
APPLICATION
DATE
7eC)