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
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W
2
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