1986, 12-11 Permit: 00014505 Insert.=
S|GNATUREOF
APPLICATION
OWNER OR AGENT DATE
JOB ADDRESS
MECHANICAL PERMIT
~~=
$25.00
PAID ~`'
COUNTER APP:
'="""~^°'
MECHANICAL TOTAL FEE
APPLi Dry 0 Range 0 Gas Log 0 Cas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE: Electric N Gas N Oil N Coal N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pomp N
Processing Fee
/wODcr-rrio`orr^ne,/
*
$25.00
10.00
15,00
"°"""'
.......
""`. = ,.~..�44.•^"
""'""=`' lREPLACE
"=`"^CTOR' lREPLACE
^="="' , .i AV
CIT`' sT:�'�'
°`
,". "CE"""�� ` '
^""°'"°".""E".
~D~"==
"'``' "`' `'"'
"^°==
C""""S=
'"""°``""'
,L^,~'
LOT & BLOCK �
FINAL
~^`°^==
,"~~~.
~"~"
FSB
5 1
5 2
RSB
"O~
"""°""="'`'
,"B°"="",,.
MECHANICAL PERMIT
~~=
$25.00
PAID ~`'
COUNTER APP:
'="""~^°'
MECHANICAL TOTAL FEE
APPLi Dry 0 Range 0 Gas Log 0 Cas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE: Electric N Gas N Oil N Coal N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pomp N
Processing Fee
/wODcr-rrio`orr^ne,/
*
$25.00
10.00
15,00
C
I NSP—I D
DATE
Ca
J
/ !i
J
st
2
MM. F