1985, 08-13 Permit App: 00007055 Mechanical Fixtures1—
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MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name/,ltasq (First) �� ¢(M)
/�" /--:ti-4:-11�A \ () w—E�11�4�
Department Use Only
Project No.
2 Project Address (Not MailingcAddress))��p / /J��� Space Zip
�'• � — bL% .xl i LI /K ' 7/C0,1-0 Co
3 City/Community
I State
%lJw
Subdivision/Plat Name
4 Assessor P cel No.
Lot
I Block
7055
16 Con for Firm Nameyy'
'Y—. .M(1,
Sl�rw.t Address
l¢• %.1// Te n7'
17 Zip
77 J-0 c
City
.a t4 o—.tea..,
State
(Li w
Phone
( ) 701 i —GP.L S 2--
16 Contact Person
License No.
Phone if different Than above
8 Owner/Ag t (Il different than N1 above)
Business
Address
9 Zip
at
State
Phone
15 Describe Work:
NewX Addition/Alteration
0
Replace/ Repair 0
10 Applica Name//''
OM .#/P
Street
Address
11 Zip
City
State
Phone
8 VENT: Fan(s):
Evap Cooler(s):
Hood
s):
Duct(s) 1: '1/
/�
Miscellaneous:
10 APPLIANCE:
Dryer(s):
1 Range s):
Gas Log(s):
Wood Stove/
Solid Fuel:
Gas Water Heater(s):
11 UNIT HEATER(S): Wall Mount: Y N
Floc
: Y N
/COO
Suspended: Y N
12 AIR HANDLING: 10,000 CFM or less:
More than 10,000CFM:
13 REFRIG SYSTEM BTU: 1-1c0M:
100-500M:
500-1000M:
14 1000-1750M:
Other:
Pressure Vessel (cu. t.):;
15 COMPRESSOR/HP: Leas than 3: I 3-15: C
15-30:
30-50: 150+:
16 GAS PIPING SYSTEM: Number of outlets:
17 HEATING SYSTEM: 1-100,000 BTU: AOOO 2' ` a_.
10Q001+BTU:
18 TYPE FUEL SOURCE: Electric 0 ; 983 )<; 011 0 ; Coe 0 ; Wood 0 ; Solar 0
19 TYPE DISTRIBUTION:. Forced Alr X ; Radiant 0 ; Heat Pump
1' Number of separate zones for any heating, A/C or air handling system.
jV-�
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.
ALDENOORF FURNACE
SIGNATURE OF A oFALLIED Hart* MCAPPLICATION
OWNER OR c 'it,! Teirkr AVE. DATE -/i—AC
SPOKANE, *A