1984, 10-29 Permit App: 00003076 Piping Indoor SpaMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1
_
Owner's Name (Last) (First) (M)
Liberty Contractors - Fred Kirkham
Department Use Only
Project No.
2
Project Address (Not Mailing Address)
S. 4314 Darcy Drive
Space Zip
99206
3
City/Community
Spokane
State
I Wash .
Subdivision/ Plat Name
4
Assessor Parcel No.
Lot
Block
16
Contractor Firm Name
Anderson's Sheet Metal -
Heating & Air Oonditionin
Street Address
E. 13903 Trent Ave.
17
Zip
6
City
IS-nokanp
State
Wash.
Phone
1( 509'928-0960
18 Contact Person
Eric R AndeKsm
License No.
ANDERSH21 NG
Phone if different than above
B
Owner/Agent (if different than #1 above)
Business Address
g
9
Zip City
Zip 715
State
Phone
Describe Work: Indoor Sa.
Gas Piping for New
Addition/ Alteration ❑ Replace/Repair ❑
10
Applicant Name
Anderson's SlE et Metal -
Beating & Air Oonditioning
Street Address
E.13903 Trent Ave.
11
Zip
9216
City
Spokane
State
I Wash.
Phone
1 1(509 ) 928-0960
8
VENT: Fan (s): _7Evap
Cooler(s):
Hood (s): Duct (s) 1:
Miscellaneous:'
10
APPLIANCE:Wood
Dryer(s):
Range(s):
Gas Log (s):
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
1000-175OM:
Other:
Pressure Vessel (cu. ft.):
15
COMPRESSORIHP: Less than 3:
3-15:
15-30:
30-50:
50+:
16
GAS PIPING SYSTEM: Number of outlets: ]
_ 5 = $2.00'
17
HEATING SYSTEM: 1-100,000 BTU: Heated Spa - beachport
Huntington Octagm 5 — L50 U ---
100,001+ BTU:
------------ 1
18
TYPE FUEL SOURCE: Electric ❑
Gas Oil ❑ Coal ❑ Wood ❑ Solar ❑
19
TYPE DISTRIBUTION: Forced Air
❑ ; Radiant ❑ 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.
SIGNATURE OF ' � APPLICATION
OWNER OR !457 _ .amort/ DATE
Eric R. Anderson, Owner
10-23-84.