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1985, 03-29 Permit App: 00004703 Mechanical Fixtures• NUMBER AND TYPE OF EQUIPMENT MECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND 1 Owner's Name (Last) Flu&ey 2 Project Address (Not Mailing Addr6ss) S 3qoa LokF+-4A (First) (M) Department Use Only LA22y Project No. J Space Zip 3 City/Community SPOKANE. State woci Sfml. Subdivision/Plat Name 4 Assessor Parcel No. 16 Contractor Firm Name T R i Uni,�ed AEEA-Tiw6 Lot Block Street Address �l 13i8 /YI4P4E 17 Zip 99at 18 Contact Person City S Po A State i4 Phone ) 39.C— S CO —PO A.I rv`cs g_ + S License No. u ?Jai 1 5 7Co Phone If different than above 8 Owner/Agent (if different than #1 above) Business Address 9 Zip City State Phone 15 Describe Work: New t8 Addition / Alteration ❑ Replace/Repair ❑ 10 Applicant Name Street Address 11 Zip City State Phone 8 VENT: Fan(s): Evap Cooler(s): Hood (s): Duct(s)1: Miscellaneous: 10 APPLIANCE: Dryer(s): IRange s)1 Gas Log(s): Wood Stove/ Solid Fuel: Gas WaterHeater(s): /— 4O, COAL - 11 UNITHEATER(S): Wall Mount: Y N Floor: Y N Suspended: Y 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: 3-15: 15-30: 30-50: 50+: 16 GAS PIPING SYSTEM: Number of outlets: 411150X1Rett291t— —1-1.00 r 17 HEATING SYSTEM: 1-100,000 BTU: IOo,000 l3T1) 100,001 + BTU: 18 TYPE FUEL SOURCE: Electric ❑ ; Gas X. ; Oil ❑ ; Coal ❑ ; Wood ❑ ; Solar 0 19 TYPE DISTRIBUTION: Forced Air 1X ; 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 APPLICATION DATE 3 c9 'c95