1988, 08-19 Permit App: 88002440 Furnace, ACMECHANICAL PERI*�1IT-AFiFi KATION WORKSHEET °
PLEASE' PRINTAND:COMPLETE'ONLY- S RTS OF'•TH ORM you. UNDERSTANR`41� a J
. i..�.1. ,• ••;�V /'n 4 r.Y1 1. 2;71�'K.1`.'r'1 ��:
•
i Owners Nem@
Last
✓_s
First.:
MI
4
Project
nrni Oct Atldreel (Street Name &.Number)•'
/ 3 2.. 01:.: X3 4 C7 S ,S'�"5°
C' y
—SPO KflPj
State
naaea.sorI Parcel I
2151 - 20
Subdivision/Me
Cw-rurir l—J — FD
8,odc
Plat /
Ao0tlGnt
Ctly [Stale
Atldrtiu
r.'
cj2ele28't
W.7 v
L
Contractor
City
C r iaC(
Lk S S L tit AJ !J E
State
Ouacrtbe Work
Llama I
Addraas
,• , k"'3'
e
8wtnees Phone
.0 JG /G
1/
fans
Evaporative Cooter
Hoods
Electric Furriaoe/CSucte
Mlaallereow
Dryer
• Range .
Oaa Lop' - .,
Gas Water Htr.,
Sofld Fuel/Wood Stove
Air Handling Unita
.
0.10'000 CFM
10,000+ CFM
a.11riQeratlon Systema/
-seal Pumas (BTU)
rl-100M
`: 101.50OM
501-1,003M
1.001.1750M • •
Over 1750M
Compressor
0.3HP //� 7
Y p `
3-15HP
15 -HP'
30 SOH?
t30+HP
Ga, ?Iptng
1-5Outleta
E+ Outlets
r Heattnp System
1-100,OOOBTU
10,1, O 7 P3 -7`•U
•
certify that the above Informatioas.submitte i. by'me,.Is,true`and.corre
n'ct and further, agree that all pro-
visions of laws and ordinances governing this:type of -work including.lnspectlon 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 provistons.of any,state of 'local.'Iaws.regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR
APPLICATION /4-_ 8 S/
DATE