HomeMy WebLinkAbout1987, 12-10 Permit App: 87004172 FurnaceMECHANICAL PERMIT APPLICATION`WORKSHEET
P:EASEPRINT AND ppm PLETE"ONLY,TH SEsPARTsS OF THEF.ORM YOU UNDERSTAND
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Ownor's Name Last
First�' • Mt
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Project Address (Street Name &Number) - " .. • -'
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State
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Assessors Parcel N
Lot
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Plat N
Applicant -
Address
City
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Badness Phone
Contractor
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Doscrtbe work
12 PLA- -1 O
GC-_ rt-C.K.i.si-eAC.
Fans
Evaporative Cooler
Hoods
Electric Furnece/Ducts
Miscellaneous
Dryer
Pangs
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
r ..
.. 101-SOOM
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501-1,000M
1,001.1750M -
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Over 1750M
Compres3or
0-31
3-15HP
15-30H P
30-50H P
50+ HP
Gas Piping .
1-5 Outlets
5+ Outlets
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Fired Heating System
1-100,000BTU10u,;AO+BTU
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l 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
OWNER OR
APPLICATION
;SATE / ,2.. --1 - 7 ?