1987, 02-25 Permit App: 87000432 Gas Log, Pipings--0
MECHANICAL PERMIT APPLICATION WORKSHEET 3,
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND"/S°
A9
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 %,, l� DATE APPLICATION, a r
OWNER OR U �C.r
Project # 7 _ 'f-1 2 .
Owner's Name Last First MI
Project Address (Street Name & Number),
%/ / / iz l c.t (��2-
City ,i-1
-4
State-
Q
Subdiv ' /Plat Name
Cri3k) 1 £w ACMES / S
Assessors Parcel #/ ._ /70
Lot ii_Block
Plat #
Applicant
Address
City I
State I Zip
I
Phone
Business Phone
ContractorAddress
ofFAT TRANSFER. :NC
City N lUti i ROM
SPOKANE, WA 99202
State
Zip
Phone
Contact 50,3) 320-3400
License 0
14'19 rt -/-/88 LA/
Business Phone
Describe Work
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log /
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000CFM
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 150+HP
Gas Piping' y Fs
1-5 Outlets
/
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10,;,00+BTU
''7t--52 -—GI.T,z, 3,), U 0 c) I6. r 4, /5 a„,0
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 %,, l� DATE APPLICATION, a r
OWNER OR U �C.r