1985, 05-20 Permit App: 00005582 Furnace1-
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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)
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Department Use Only
Project No.
2 Project Address (Not Mailin ddress Space Zip
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3 City/Community
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States (
l-3`1 G�--,
SubdivisionlPlat Name
RJ
4 Assessor Parcel o.
Lot
I Block
65FZ
16 Contractor Firm Name
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%.c.gt Address
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17 Zip
?LOC
City
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State
e_k_JG___
Phone
( ) 7) --ini s &-
18 Contact Person
License No.
Phone if different than above
8 Owner/A ent (if different than`�#1 above)^
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Business
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Address7.`'
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g Zip
City
State
Phone
15 Describe Work: (f
New> Addition/ Alteration
❑
Replace/Repair 0
10 Applica Name
Street
Address
11 Zip
City
State
Phone
( )
8 VENT: Fan(s):
Evap Cooler (s):
Hood s):
Duct(s)1:
Miscellaneous:
10 APPLIANCE:
Dryer(s):
I Range s):
Gas Log(s):
Wood Stove/
Solid Fuel:
Gas Water Heater(s):
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:
13 REFRIG SYSTEM BTU: 1-100M:
100-500M:
500-1000M:
14 1000-1750M:
Other:
Pressure Vessel (cu. t.):
15 COMPRESSOR/HP: Lessthan3:
3-15:
15-30: 130-50:
50+:
16 GAS PIPING SYSTEM: Number of outlets:
7
17 HEATING SYSTEM: 1-100,000 BTU: j�/ / y S / S J
100,001 + BTU:
18 TYPE FUEL SOURCE: Electric ; Gas ❑ ; 011 0 ; Coal 0 ; Wood 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. ALDENDORF FURNACE
A DIVISION OF ALLIED HEATIP , INC.
SIGNATURE OF E. 9311 TRENT AVE, APPLICATION
OWNER OR -$POKANF, WA 99206 DATE
9284292