1988, 09-12 Permit App: 88002787 FurnacePLEASE:PRIN
MECHANICAL I!ERNIITAr:`M EET
�IgT6of,Tostfolim YOU UNDERSTAND
yam .�, 2 EO- 2C_o0
owner 'a Name
OMPL,ETE ONLY
IProject
First,. MI
Last •
1-6 /� 7"a- t . /4 (LD 1� -
Project Address (Strait Name & Number) •'
State
City
St,°&L R L
54--17.
Assessor$ Parcel r
Applicant
4
*Ad' A/Plat Name
!8 6
Plat
• Phone
Contractor
B v' /�
Business Phone
,99?
Address,
cny /�//fit -
a�� " '�`' B sins$ Phone
Contact . Llwnser
�u S'S LsAnr De. . s>t.4i1/, '/ 3 4/�
Phone L5 // //
Describe Work
Fans Eva
Dryer
Alr Handling Units
1/
ponllw Cooler Electric Furnace/ducts Miscellaneous
Hoods
Rang
Gas Water Htr. Solid Fuss/Wood Stow
0.10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (STU)
1-100M
101.600M
501-1,000M
1,001.1750M
Over 1750M
•, :':4
Compressor
Gas Piping
3-15HP
1-6 Outlets '
115.30HP
30-50HP 150+HP
it Outlet:
(Gaa-Fired Heating Systsm
RLL
,-100,000871.►
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I certify that the above information as submitted r by:'�me untrue 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 anystate of local laws regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR
,DATE
APPLICATION �2 '3
_