1988, 04-15 Permit App: 88000896 ACWi I ����+LyCATCON WORKSHEET 15 :
MECHANICAL PER��
PLEASE ,PRINT, 'AND COMPLETE`ONLY S t TS O,T�{HORM YOU UNDERSTA a
.,:�• r r�Y;'A A
.' AS
r
Project N
Owner's Name
Wt First;... MI
, L ���- t �(V , J
Protect Address (Street Name d. Number) • `
``
c+tyS
State
subdivision Plat Name
eo K A
W A
Assessors Parcel N
Lot.: • Stock. Plat N
1
Applicant
�..' Address
City
State
7! 21P ` � Phone
,r 2—
Business Phone
Contrsetor
/►' Gs/tate.
�ddress�
City
I
�v����l%�� Plane
-Me
Contact
Lloeeenee N
��
Business Phone
!/
u c
J
.i 4� �:+
Li/t N
L.r>�/s'/•
/ ✓. 4
Describe Work
Fens
Evaporative Cooler Hoods
Electric Furnsce/DuCtll MlsoNlansous
.Range
Gas Log':.
Gas Water Htr..
Solid FuN/Wood Stow
Dryer
010,000 CFM
10,000+ CFM
Air Handling Units
Refrigeration Systema/
1-t00M
101.-600M 501-1,000M
Meat Pumps (BTU)
1,001-1750M
Ova'1750M
03HP 3-15HP
16.tOHP' 3050HP liO+His
Compressor
'1
�• - +
1-S Outlets
6 + Outlets
Gas Piping
1-100,000BTU
10v,..t70+td'1U
Gas Fired Heating system
certify that the above Information assubmltte� 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: ofa,.permlt 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 APPLICATION
OWNER OR ,DATE