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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 raoyso 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