1985, 07-03 Permit App: 00006364 Mechanical Fixtures*
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) Irst) (M)
Department Use Only
nu
--().� TNA . TT VEL 1 --Lt
Project No.
2Fiziect Address (Not Mallin Address) Q 0 Space Zip r
t.. ,"101-.1 S 1-tti-a�u` mac"t..1...L_e_Yo C
`
3 City/Community
u'
State
Subdivision/Plat Name
4 Assessor Parcel o.
43551
Lot 1
Block
(,n ;
16 Coner.kor Firm NameStreet
7
�_ ._-k_,.> ,z� o.)----
ddrees
2 (i '--)4').—i-•..1-
_8
17 Zipc q
CI
State }
Phone ) � /2 ��
18 Contact Person
J
License No.
Phone If different than above
8 Owner/Agent (If different than #1 above)
QA—.1)._.21 111.4.),Cit
,CL ahl.d
Buel
Address
4. eF(
.
9 Zip
9 9c A.7
t k . .k .._
State
v`..)i.:
( )
15 Describe Work:
New -NKAddition/Alteration 0
Replace/Repalr 0
10 Applicant Name
Street
Address
11 ZIp
City
State
Phone
( 1
8 VENT: Fan(s):
EvapCooler(s):
Hood (10:
Duct(e)1:
Miscellaneous:
10 APPLIANCE:
Dryer(s):
Range s):
Gas Log(e):
Wood Stove/
Solid Fuel:
Gas Water Heater(s): /fit(
11 UNIT HEATER(S): Wall Mount: Y N
Floor: Y N
Suspended: Y N
12 AIR HANDLING: 10,000 CFM or less:
More than 10,000 CFM:
J 13 REFRIG SYSTEM BTU: 1-100M:
100-500M:
500-1000M:
)
J 14 1000-1750M:
L
Other:
Pressure Vessel (cu. ft.):
1 15 COMPRESSOR/HP: Less than 3:
3-15:
15-30:
30-50:
50+:
L
u16 GAS PIPING SYSTEM: Number of outlets: �
W
0
S j
c v t;)D 17 HEATING SYSTEM: 1-100,000 BTU: / c 0 � `. lj ,.100,001
+ BTU:
18 TYPE FUEL SOURCE: Electric 0 ; Gas X; 011 0 ; Coal 0 ; Wcod 0 ; Solar 0
19 TYPE DISTRIBUTION: Forced Air ; Radiant 0 ; Heat Pump
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. ALDENDOPF FURNACE
A DIVISION OF ALLIED HEATING, INC.
E. 9311 TRENT AVE.
SKAANE, WA 99206
SIGNATURE OF
OWNER OR
9284252
APPLICATION
DATE