1986, 07-01 Permit: 00011926 FurnaceSIGNATURE OF APPLICATION
OWNER OR AGENT DATE
JOB ADDRESS PROJECT �t
MECHANICAL PERMIT
SEG.
DATE:
FEES:
PAID BY:
G
N
COUNTER APP:
PLANS EXAM:
DATE:
:'LL_ p l 1:,9 r! .i. 4..; i 1_. TOTAL F L. L.
;::A`1" '::::'r`':;1'E::li (BTU); 100K or Less 01 Over 100K 0 I"'( t
E:. i... SOURCE: Electric N . Gas =:s Y t) i :l A! Coal N Wood NSolar N
RI1 i,1'i :lt:ifel: Forced ce:ici Air� Radiant N Heat Pump N
Frit -., i.nq Fee
INSPECTOR'S COPY
$.'4 , U 0
9,00
OWNER:
ADDRESS:
CITY: ST: ZIP:
APPLICANT:
CONTRACTOR:
ADDRESS:
CITY: ST: ZIP:
pH: LICENSE*:
ARCH/ENGINEER:
ADDRESS:
CITY: ST: ZIP:
PARCEL.: (CENSUS TR:
INSPECTOR:
PLAT.:
LOT & BLOCK
FINAL
PLAT NAME:
ZONE.:
ZONE
FSB S - I
RSB
MOD
_S/-2
C161.
USE OF PERMIT: a
JOB ADDRESS:
Rtr
MECHANICAL PERMIT
SEG.
DATE:
FEES:
PAID BY:
G
N
COUNTER APP:
PLANS EXAM:
DATE:
:'LL_ p l 1:,9 r! .i. 4..; i 1_. TOTAL F L. L.
;::A`1" '::::'r`':;1'E::li (BTU); 100K or Less 01 Over 100K 0 I"'( t
E:. i... SOURCE: Electric N . Gas =:s Y t) i :l A! Coal N Wood NSolar N
RI1 i,1'i :lt:ifel: Forced ce:ici Air� Radiant N Heat Pump N
Frit -., i.nq Fee
INSPECTOR'S COPY
$.'4 , U 0
9,00
INSP-ID
DATE ?i�.�l�