1987, 10-23 Permit App: 87003595 Inserty.
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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Protect# .s51J5
Owner's Name Last First MI
NARiga J Ael<
Project Address (Street Name & Number)
E/a3A3 inA0,y Ct•
Cityc rue
6 Pak !V
State -,4S
Subdivision/Plat Name
Assessors Parcel #
Lot
Block
Plat #
Applicant
MAklOa,U 4,1t'0 -l<
Add ess
k is3a3 /1AC.y L'/.
City
SpdkANe
State
L 6 -s X
Zip
99aib
Phone
9a S/- 4'85/7
Business Phone
Contractor
S,941e ,4-s 4b6t'e
Address
City
State
Zip
Phone
Contact
License #
Business Phone
Describe Work
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
7 fir -4.-4357
Air Handling Units
0-10,000 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
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10u,000+BTU
Zc .c7
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.
SIGNATUREOOFAift_
OWNER OR -7 •
APPLICATION
DATE