1986, 04-10 Permit App: 00010406 Furnace90 10042644.40W1
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT)ND 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���� APPLICATION
OWNER OR
DATE y�/�
Project #
Owner's Name Last First MI
'IROTTA CHARLES
Project Address (Street Name & Number)
E. 8205 Glass
City
Spokane _
State
WA
Subdivision/Plat Name
Assessors Parcel #
Lot
Block
Plat #
Applicant
Aix Design Heating and Refrigeration, Inc.
Address
E. 1807 Francis
City
Spokane
State
WA
Zip
99207
Phone
487-4328
_
Business Phone
Contractor
Address
City
State
Zip
Phone
Contact
Barbara
License #
AIl?DEI#161JW
Business Phone
487-4328
Describe Work
Install 82,000 BTU gas furnace $27.00
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
101-500M
501-1,000M
1,001-1750M
Over 1750M
Compressor
0-3HP
3-15HP •
15-30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets9,
X
5+ Outlets
Gas Fired Heating System
1-100,000BTU q
X
''
1Q,,;0O+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���� APPLICATION
OWNER OR
DATE y�/�