1987, 11-12 Permit App: 87003883 FurnaceS.i` '..• .r..:,i --McGee-Q"2
MECHANICAL PERM IT-APPL"•ICATION''WORKSHEET
PLEASE PRINT 'AND COMPLETEONLY,
hPgRTt s OF, THF; ORM YOU UNDERSTAND
4
41d
I certify that the above Information as..'submltted by'me,ls-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 APPLICATION l
OWNER OR DATE l ( 3 r�
Project N
Owner's Nam. Leat First . MI
Co .G?wfrL .. etPA-5
Prtllect Adores& (Street Nam. & Number)'s Erc2 :.' w to /J. 44.
City$tale
SP
Subdivision/Plat Nam.
Aisessore Parcel N 5
, q/Lot
L
Block '
Plat 1
Applicant ^
Addts a
CityStat.
s�l«� I . wtef
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Businese Phone
Contractor
17f9A/A/ i .Z-- Ce ,..
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City
Stale,,,,,,..`�
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contact
' Z u s s L L't nJ D E.
LicensesBut
/f74i/ -/-3749/4/7--.
Ineee Pion.
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Doscrlbe Work __ L A—S FuK-)
Fans
EvaporattveCooler
Hoods
ElectrcFurnace/Ducts
Mlecellaneous
Dryer
Range
Gas Log''','
Gas Water Htr,
Solid Fut/Wood Stove
Alr Handling Unita
0.10,000 CFM
10,000+ CFM
anrrIgeratlon Systems!
-teal Pumps (8TU)
1-100M
101-SOOM
501-1,000M
1,001-1750M
ti:
Over 1750M
Compressor
0-3HP
3-15HP
15a0HP
30-50HP
50+HP
Gas Piping
1-5 Outlets -
6+ Outlets
Gas Fired Heating System
t-100,000BTU
1uu...00+ilt v
42f,,,vo,„ G i t Q J— /3 7
I certify that the above Information as..'submltted by'me,ls-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 APPLICATION l
OWNER OR DATE l ( 3 r�