1985, 12-09 Permit App: 00009114 Wood Stove✓.
MECHANICAL PERMIT APPLICATION WORK$WlfT
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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1 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
1II APPLICATION q
Pf t4��.11• ��� DATE d j 7
Project # Q/ / 1 --
Owner's Name Last First MI
Powell Richard
Project Address (Street Name & Number
E. 12407 Lenora Drive
City
Spokane
State
WA 99 216
Subdivision/Plat Name
/-I'LL yr .tw IL -STATES
5, /3 — ^' q.51 3
Assessors Parcel # Z75173
[7L V
Lot / 03 ck?
Plat #
Applicant
Address
City
State
Zip
Phone
Business Phone
Contractor
Valley Fireplace
Add ess
E. 16610 Sprague - PO Box 553
City
Veradale
State
WA
Zip
99037
Phone
922-2780
Contact
License #
VALLEF 177CC
Business Phone
trt,w,,-
Describe Work Installation of Convector II woodstove, some1pipe •
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Wale Htr.
Solid Fuel/ Wood Stove
Yes — see above
Air Handling Units
o-10,000 CFM
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
50+HP
Gas Piping
1-5 Outlets
5+ Outlets
Gas Fired Heating System
1-100,00OBTU
10,,L00 + BTU
1 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
1II APPLICATION q
Pf t4��.11• ��� DATE d j 7