1985, 09-17 Permit App: 00007705 Heat Pump'- - - MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
11
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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 APPLICATION
OWNER OR .DATE
!- U 1-166K
Project # V S.
Owner's Name
Ma and
Last First
Terry
MI
Project Address (Street Name & Number)
E. `16512 Longfellow'
City
Spokane
State
WA
Subdi Ialon/Plat Name A �
M` ;;N -4 V/�� foo
#I
Assessors Parcel #`
f /� 3
Gv '— 4
Lot
Block _
Plat N
Applicant
Ma and
Terry
Address
E. 16512 Longfellow
City
Spokane
State Z
WA
ip
99206
Phone
928-9178
Business Phone
Contractor
Sturm Heating, INC
Address
E. 204 Indiana
City
Spokane
State '9'P9
WA
ip
99207
Phon
X325-4505
Contact
Diane
License #Busi
ST -UR -MI -210 -QF
one
TT4505
Describe Workt
Inall
heat* pump.
00'
Fans
Evaporative Cooler
1
Hoods
Electric Furnace/ Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
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
7H
315HP
15 30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets
5+ Outlets
Gas Fired Heating System
1-100,000STU
1W,:,W+BTU
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 APPLICATION
OWNER OR .DATE