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1986, 12-05 Permit: 00014429 Furnace, PipingSIGNATURE OF OWNER OR AGENT JOB ADDRESS MECHANICAL PERMIT APPLICATION /1/s/�/b DATE PROJECT# 5E0. .: DATE: 4fe. 27 On FEES: PAID BY: 0 N COUNTER APP: PLANS EXAM: DATE: MECHANICAL TOTAL. FEE:: GAS PIPING SYSTEM: Quantity 01 Fee HEAT SYSTEM (BTU) : 100K or Less 01 Over 100K 0 Fee FUEL SOURCE: Electric N Cas N Oil N Coal. N Wood N Solar N Processing Fee 12-05=86 OFFICE COPY $217.00 3.00 9.00 15.00 668.62 *27.00 OWNER: AOORESS: CITY: 5T: ZIP: APPLICANT: CONTRACTOR: ADDRESS: 1 0 k3 ..' 1:, CITU(: (/ }} k ST:`1 WA ZIP: i:;p OKAi•'J' W:^i P1.: LICENSEW: ::. i'F 1..7 926-7509 ARCH/ENGINEER: ADDRESS: CITY: 5T: ZIP: PARCEL.: CENSUS TR: 099906 INSPECTOR: PLAT.: 'I(( 0 ' 0 .A LOT & BLOCK 0 0 f.. .. .. FINAL PLAT NAME: ZONE.: ZONE FSB 0 0 0 5-1 5-2 R5B 0 0 0 MOD I.: USE OF PERMIT: JOB ADDRESS:: [�/�j( :'..y 1: GRACE AV MECHANICAL PERMIT APPLICATION /1/s/�/b DATE PROJECT# 5E0. .: DATE: 4fe. 27 On FEES: PAID BY: 0 N COUNTER APP: PLANS EXAM: DATE: MECHANICAL TOTAL. FEE:: GAS PIPING SYSTEM: Quantity 01 Fee HEAT SYSTEM (BTU) : 100K or Less 01 Over 100K 0 Fee FUEL SOURCE: Electric N Cas N Oil N Coal. N Wood N Solar N Processing Fee 12-05=86 OFFICE COPY $217.00 3.00 9.00 15.00 668.62 *27.00 INSP-ID DATE "i7/9467 t9 4 S U W 2 W J1J1 Q E 0 W 0 U J W CC 2