Loading...
1986, 01-27 Permit App: 00009587 Furance• MECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND 1 Owner's Name (Last) (First) (M) Department Use Only ,c..k. (,,,_,...L.1... , + Project No. 17 i 2 Project A. dress (Not Mailing Address) F,, Space Zip y 3 City/Commu " y LS.__ State L_k j ',L._ Subdivision/Plat Name 4 Assessor P el No. Lo 1 Block 16 Contracjor Firm Name . --< (_).,_ (,.c V.A.L._ c -e* ,-14.._i.,\.-t..-t", — Str Address s,,,....... r._,7";3//4:-A- ,7";I/�\� 1� 17 Zip 1 C/ fff City State Phone / 18 Contact Person . License No. Phone If different than above 1111111.20004 1 f 8 Ownei...6.- ____tire Ltabove) t��� /I I ,ii A C`, ,rasa /5/j F- 9 Zip �G. ) iG'{s 'r T"/ / City • ) °" ..._.Q� �"'C mil _ State � L'—"- -L Phone ( 15 Describe Work: New X Addition/ Alteration 0 Replace/Repair 0 10 Applicant Name Street Address 11 Zip City State Phone ( ) 8 VENT: Fan(s): i Evap Cooler(s): L Hood s): Duct(s)1: x67 ,..3 6) _ Miscellaneous: 10 APPLIANCE: Dryer(s): I I Range s):'s Gas Log(s): Wood Stove/ Solid Fuel: Gas Water Heater(s): 11 UNITHEATER(S): Wail Mount: Y N Floor: Y N Suspended: Y N 12 AIR HANDLING: 10,000 CFM or Tess: 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: Lessthan3: 3-15: 15-30: 30-50: 50+: 16 GAS PIPING SYSTEM: Number of outlets: 17 HEATING SYSTEM: 1-100,000 BTU: '-jT' ' .-e 100,001 +BTU: 18 TYPE FUEL SOURCE: Electric "; Gas 0 011 0 ; Coal 0 ; Wood 0 ; Solar 0 19 TYPE DISTRIBUTION: Forced Alr Radiant 0 ; Heat Pump 1* Number of separate zones for any heating, A/C or air handling system. 2/ c� 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. ALDENDORF FURNACE SIGNATURE OF A SIM OF ALLIED HEATING, INC APPLICATION OWNER OR E 4311 TREK! AVE. DATE ° / � SPOKANE, WA 99206