1987, 04-24 Permit App: 87001105 Heat PumpMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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_ DATE.
Project N
Owner's Name Last Firet MI •
Massey John
Protect Address (Street Name & Number)
S. 4311 Forest Meadows Dr.
City
Spokane
State
Wash.
Subdivision/Plat Name
Assessors Parcel #
Lot .
Block
Plat M
Applicant
John Massey
Address
S. 4311 Forest Meadows Dr
City
Spokane
State
Wash.
Zip
99206
Phone
922-1599
Business Phone
Contractor
STURM HEATING, INC.
Address
E. 2D4 Indiana
City
Spokane
State
WA
Zip
99207
Phone
325-4505
Contact
Sherry
License M
STURMI* 210 QF
Business Phone
325-4505
Describe Work
Install Heat pump system $24.00
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
9 . 0 0
101-500M
501-1,000M
_
1,001-1750M
Over 1750M
HP
10-3Compressor
3-151-1P
15 -301 -IP
30-50HP
50+HP
Gas Piping
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10v, :AO + BTU
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_ DATE.