1987, 11-05 Permit App: 87003885 Furnace, PipingH
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MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE O1'JLY THOSE PARTS OF TI -,E FORM YOU UNDERSTAND
ac4o SF IC 56
1 Owner's Name (Last) (First)�1 (M)
NJ� KSO n/ 4ND 'f
Department Use Only n
Project Na.985
2 Project Address (Not Mailing Address) Space Zip
/,fl / f . 11Y °Y £2/et
3 City/ Community
cCdo KAAi
State1(///9
Su sic /Plat Name
LS ra GST
4 Assessor Parcel No.
2-1S412 -•- 3301/
Lot
rt
Block
'L
16 Contractor Firm Name
.-1----./.4/4;..,..?„...../4-4--2., ///Y/2Gof1—
Street Address
Cl' . 9 /r// /�/�-r
17 Zip
City
State
Phone
18 Contact Person ,if
LIce05flN9.
Phone If dif/erent than above
�����e�s�s/��
s4WGK00041
8 Owner/Agent Of different than 41 above)
I Business
Address
9 Zip
City
State
Phone
15 Describe Work:
New 0 Addition/Alteration ❑
Replace/Repair 0
10 Applicant Name -
Street
Address
11 Zip
City
State
Phone
8 VENT: Fan(s):
Evap Cooler(s):
Hood ):
Duct(s) 1:
Miscellaneous:
10 APPLIANCE:
Dryer(s):
I Range s):
Gas Log(s):
Wood Stove/
Solid Fuel:
Gas Water Heater(s):
11 UNIT HEATER(S): Wall Mount: V N
Floor; Y N
Suspended: V N '
12 AIR HANDLING: 10,000 CFM or less:
More than 10,000 CFM:
13 REFRIG SYSTEM BTU: 1-100M:
100-500M:
500-1000M:
14 1000-1750M:
Other:
Pressure Vessel (cu. t.):
15 COMPRESSOR/HP: Less than 3: 13-15:
15-30: 130-50:
50+:
16 GAS PIPING SYSTEM: Number of outlets: 6) so l '
aa
17 HEATING SYSTEM: 1-100,000 BTU' (5 1 r 9
Y
100,001 + BTU:
18 TYPE FUEL SOURCE: Electric 0 , Gas 1/
ut,; Oil 0 Coe 0 Wood 0 Soler 0
19 TYPE DISTRIBUTION: Forced Air 0 ; Radiant 0 ; Heat Pump
1' Number of separate zones for any heating, A/C or air handling system.
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.
SIGNATURE OF
OWNER OR
ISD aVa:sei fr ,=0bindm' ACE
A DPt{`.e$ION OF ALLIED HEATING, f'!C
n^. 11 vnfl.rr Alate
SPOKANE, WA 99206
9284252
APPLICATION
DATE ///6.—/
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