1988, 03-08 Permit App: 88000421 FurnaceMECHANICAL PER114IT APPLICATION' WORKSHEET
-Ft_EASE PRI NT AN D4C0_MPLETE•ON.LY. THE FORM YOU UNDERSTAND
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I certify that the above Information as'submitted by me.Islrue•and correct and further, agree that all pro-
visions of laws and ordinances governing this:type of work; including Inspection requirements, will be com-
' iied with whether specified herein or not: The granting of a•permlt 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 3y_ g,pj
DATE
Protect I
Owner's Nam. Lust Find MI
Sar 1 ,s , mss
Project Address (Street Nam. & Number)•' c r,.'`,
1 o .. •, � 4547 NF °( 2 to
City
State
$ubdlvIslon/Plat Name
7
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Assessors Parcel N i l 4) S`i ) F1 IV '
Lot ' a
Black -Plat
0
Applicant .4-) 1 E
City
S e K C
State ?'
w 4
'•7aP`:
!p206
Phone
,....
auelnees Phone
Contractor
/
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Addreug/9/../V i !q, ✓//j/` / -
City
.1,'44)<4t -/S',
,
Stale
9'
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.S'3..C_/7//
Contact
RLS s L LA F_ _
License II
1f1,/.zvA /37,4/7
Business Phone
a
Describe Work
Fans
Evaporative Cooter
Moods
Electrk Fumace/ducts
Miscellaneous
Dryer
Range
t3ss Lop''
Oaa Water Htr.
Solid Ful/Woad Stove
Air Handling Units
0-10,003 CFM
10,000+ CFM
Refrigeration Systems/
Haat Pumps (BTU)
1.100M
101-500M
501-1,000M
1,001.1750M - •
Ova 1758M
Compressor
O-3HP
3-15HP
15-3OHP
30-SOHP
50+HP
Ga: P!pinc
1-5 Outlets
e+ Outlets
Heating System
0/Z.1-100,000BTU
10v,o00+BTU
,CN�OX o t�oq3 --i 0.5
. '"•ir r ...
• r:�1,rr:,;,{�,:;
I certify that the above Information as'submitted by me.Islrue•and correct and further, agree that all pro-
visions of laws and ordinances governing this:type of work; including Inspection requirements, will be com-
' iied with whether specified herein or not: The granting of a•permlt 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 3y_ g,pj
DATE