1986, 09-11 Permit: 00013076 WoodstoveSIGNATURE OF
OWNER OR AGENT
JOB ADDRESS
MECHANICAL PERMIT
APPLICATION
DATE .
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PROJECT#
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$25,00
PAID ^`'
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COUNTER API,
PLANS EXAM:
MECHANICAL TOTAL FEE
APPL: Dry 0 Range 0 Gas Log 0 Cas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE: Electric N Cas N Oil N Coal N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pomp N
Processing Fee
$25.00
10.00
15,00
09-11-S6 501,5 *25,006
OFFICE COPY
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ADDRESS: ....AR
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CONTRACTOR:
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LICENSE.:
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PLAT NAME:
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USE OF PERMIT:
MECHANICAL PERMIT
APPLICATION
DATE .
=��
/\ »� c��,
� __
PROJECT#
=~°'
$25,00
PAID ^`'
°
COUNTER API,
PLANS EXAM:
MECHANICAL TOTAL FEE
APPL: Dry 0 Range 0 Gas Log 0 Cas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE: Electric N Cas N Oil N Coal N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pomp N
Processing Fee
$25.00
10.00
15,00
09-11-S6 501,5 *25,006
OFFICE COPY
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