1986, 10-24 Permit: 00013839 WoodstoveSIGNATURE OF
OWNERORAGENT / / ~ ' DATE
APPLICATION
JOB ADDRESS
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101 S LONG RD
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ADDRESS: LONG RD
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CONTRACTOR:
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MEChANICAL
FEES:
1,25,00
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COUNTER APR: 113(itz)
PLANS EXAM:
DATE:
MECHANICAL PERMIT
MECHANICAL TOTAL FEE
APPL: Dry 0 Range 0 Cas Log 0 Cas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE; Electric N Cas N Oil N Coal N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pomp N
Processing Fee
$25.0�
10.00
15.00
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