1988, 09-28 Permit App: 88003122 FurnaceMECHANICAL PERMIT''APPLICATION WORKSHEET
PLEASE PRINT ANappy PLETE'ONLY.THISEiFAF,ITS,OFATHE,FORM YOU'UNDERSTAND
I certify that the above Information as submittede,,Is true thldg rr ct annd turfreqler, afire, wllltbelvisions of laws and ordinances governing thls,type of
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 �J
APPLICATION q _2 S--"-1,
DATE /
Protect ‘1v
Owner 'a Name lest First MI
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Prolan Address (Street Name & Number)
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city
.Srs
ee (c -Hc
State
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Subdivision/Plat Name
. .
Assessors Parcel a
LDL
Block
Fiala
Applicant ..
Address
city
Stele
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a
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Business Phone
I
Contractor //77 .. // R ��••--'' /�
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State
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Phone
5� 5:-/7//
Contact Ru S s L -t t rat D F_
License a •&sines
AedA7/1/t/5 37r/✓/
Phone
ri
Coeclbe WorktedO i L ^ _ 1e
,^J``
-y
�L `
,root
LDrYer
Evaporative Cooler
Hoods
Electric Furnace/butts
Misc&leneoua
Pangs '
Gm Log 5 '
Gm Water Htr.
Solid Fuel/Wood Stove
Air Handling Unita
0-10,000 CFM
10,000+ CFM
~ RefrIperauon Systems/
�
.seal Pumps (BTU)
1-10OM
101-500M
501-1,000M
1,001-1750M '-
Over 1750M
Compressor
0-3HP
3-151(P '
15J0HP
30-5OHP
50+HP
Gas Piping
1-5 Outlets '
S+Outlets
s cIIM HealIng Syalem
1.100,0038TV
se:.'iy° K io/G Q,3 — 7 0
t0,,,:AO+BTU
. ..
.. n .. ... '
I certify that the above Information as submittede,,Is true thldg rr ct annd turfreqler, afire, wllltbelvisions of laws and ordinances governing thls,type of
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 �J
APPLICATION q _2 S--"-1,
DATE /