1985, 04-09 Permit App: 00004886 Mechanical Fixtures*
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MECHANICAL PERMIT APPLICATION WORKSHEET Fee 10.00
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
T-
1 Owner's Name (Last) (First) (M) l Department Use Only
iia '1ST, INC. I Project No.
2 Project Address (Not Mailing Address) Space Zip
E. 11920 Diana 99206
3 City/Community
Jho" .8ne
State
)2.shington
Subdivision/ Plat Name
4 Assessor Parcel No.
Lot
Block
•
16 Contractor Firm Name
Anderson's Sheet Petal - Heating & Air uonditionin.g
Street Address
E. 13903 Trent Ave.
17 Zip
9216
City
Snone
State
-`:Ta.sh; ngton
Phone
1( 509) 925-0960
18 Contact Person
Eric H. Anderson
License No.
A ?D%R: 3TT213 r4'L
Phone if different than above
8 Owner/Agent (if different than #1 above)
Business Address
9 Zip
City
State
Phone
( )
15 Describe Work:
New - Addition/Alteration ❑ Replace/Repair ❑
10 Applicant Name
Anderson's Sheet Metal - Heating , «ir Conditioning
Street Address
E. 13903 Trent Ave.
11 Zip
99216
City
Snoknne
State
':ias7ino iron
Phone
1 609 ) 92,-0760
8 VENT: Fan(s):
Evap Cooler(s):
Hood s):
Duct(s)1: -Miscellaneous:
10 APPLIANCE:
Dryer(s): 1
Range s):
Gas Log (s):
Wood Stove/
Solid Fuel:
i or -ii to 40,000 000 BTU Gas
Gas Water Heater(s): 1ate r I r.
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:
30-50:
50+:
16 GAS PIPING SYSTEM: Number of outlets: 'LH° 0il-t1otS
17 HEATING SYSTEM: 1-100,000 BTU Rheem Hox z ona1 75,000 bTU
Gas Furnace.
100 001 + BTU:
18 TYPE FUEL SOURCE: Electric ❑ ; Gas 1E; Oil ❑ ; Coal 5 ; Wood 5 ; Solar ❑
19 TYPE DISTRIBUTION: Forced Air . ; Radiant 5 ; Heat Pump CI
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.
SIGNATURE OF
OWNER OR
c R. Anderson, �� n',r
APPLICATION
DATE
I.-9-iS5