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1987, 10-16 Permit App: 87003485 FurnaceMECHANICAL PE iiMitAPOLICAT(ON 'WORKSHEET PLEASE ,PRiNT AND;COMPLETE•4NL:Y. "Fs• T.H ;FORM YOU,,UNDERSTAND 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. SIGNATURE OF OWNER OR APPLICATION DATE /0- 7-077 Project s Owner's Name Last First MI K-Ni.�Z.o`i s. Project Address (Street Nam• & Number)..' l O o s; 3 ko co stale 4Asse+S$0kArIU6- (N 6-- Subdivision/Plat Name ' Assessors ssors Parcel 0 r Lot Block Plat 0 ApplicantrMs A-7y7 %dd Cny slat. Seo � X_wA- •, _...P9..2ot. .. 9 24, I G 7 7 Busln•ss Phone • _ ._ --_. - Contractor 17/9A ✓ /,C1 / 4- , . AddrW ,.d. �,Jy_3�f1© City Slats ``,A,// — Contact . R LA S S L (A DDE. _ Llo•nse 0 Al. 1/, �i�.37 4/7 Bus lnoes Phone Describe Work Fans Evaporative Cooler Hoods Electric Furnace/duct. Miscellaneous Dryer Range • Gas Log' ': Gas Water Htr, Solid Fuel/Wood Stove Air Handling Units 0.10,000 CFM 10,000+ CFM Refrigeration Systema/ -teal Pumps (BTU) 1.100M 101.600M 501-1,000M 1,001.1750M Ow 1750M iI Compressor 0-3HP 3-15HP 163OHP 30-5OHP 50+HP G83 Piping 1-5Outlsts 6+ Outlets Gas Fired Heating System _At.✓No1( 1-100,0008TU G/6 G3/y Joo 1G 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. SIGNATURE OF OWNER OR APPLICATION DATE /0- 7-077