1985, 01-17 Permit App: 00003948 Wood StoveZ
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MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) (First) (M)
Department Use Only
Sutton Beverly
Project No.
2 Project Address (Not Mailing Address) Space Zip
8 2510 Bates Road
3 City/Community
Spokane
State
Wash
Subdivision/Plat Name /'
��cyw�t,J (tc
4 Assessor Parcel No
29i5.ti-0is2-l
Lot
`z
Block
b
16 Contractor Firm Name
Pleasant Prairie Farms Custom Mfg.
Inc.
Street Address
E 7827 Bigelow Gulch
17 Zip
99207-9698
City
Spokane
State
Wash
Phone
1 509 467 6760
18 Contact Person - -
J. Gramlow
License No
223 01
PLeasi* 229 JE
Phone if different than above
8 Owner/Agent Of different than #1 above)
Business Address
g Zip
City
State
Phone
( )
15 Describe Work: Catalytic Stove Installed
Hearth by Cunt64Ar Addition/Alteration
by PPF Masonary Chimney by M. Bailey
0 eplace/Repair
10 Applicant Name
Street Address
11 Zip
City
State
Phone
8 VENT: Fan(sy
Evap Cooler(s):
Hood a)•
Duct(s) 1'
Miscellaneous:
10 APPLIANCE'
- Dryerlsp
1 Range s)'
Gas Logls):
Wood Stove/
Solid Fuel
Gas Water Heater(s)i
11 UNITHEATER(S): Wall Mount: V N
Floor Y N
Suspended: Y N
12 AIR HANDLING' 10,000 CFM or less:
More than 10,000 CFM:
13 REFRIG SYSTEM BTU: 1-100M:
100-500M
503-1000M:
14 1000-1750M.
Other:
Pressure Vessel (cu. t.).
15 COMPRESSOR/HP' Less than 3:
3-15:
15-30:
30-50:
50+'
16 GAS PIPING SYSTEM Number of outlets.
17 HEATING SYSTEM: 1-100,000BTU•
103,001+BTU'
18 TYPE FUEL SOURCE: Electric 0 ; Gas 0 ; Oil 0 ; Goa 0 ; Wood D : Solar 0
19 TYPE DISTRIBUTION: Forced Air 0 ; Radiant 0 ; Heat Pump0
1* Number of separate zones for any heating, A/C or air handling system.
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.
SIGNATURE OF
OWNER OR
APPLICATION
-`'J DATE