1984, 09-27 Permit App: 00002542 FurnaceMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1
Owner 4 Nj3pe (Last)
first)
(M)
Department Use Only
Project No.
2
Projec Address (Not Mailing Address)
/U. 3 z 2-3 Zeis ,moo
Space Zip
3
Cityl mmunity
OKi'lT��
State
Subdivtslo at a e N
at N tyC(/
4
Assessor Parcel No.
D& 3 - 38
Lot
Block
!�
16
Contractor Firm Name
Alpine Energy, Inc.
Street Address
I E. 3003 Sharp
17
Zip
99202
City
Spokane
State
Washington
Phone
( 509) 534-4722
18 Contact Person
Dwayne Phinney
License No.
ALPINEI175N9
Phone if different than above
8
Owner/ Agent (If different than N1 above)
Business Address
9
Zip
City
State
Phone
15
Describe Work:
New ❑
Addition/Alteration ❑ Replace/Repair B._
10
Applicant Name
Street Address
11
Zip
City
State
Phone
8
VENT: Fan (s):
Evap Cooler (a):
Hood(s):
Ducts) 1:
Miscellaneous:
10
APPLIANCE:
Dryer(s):
Range(s):
Gas Log is):
Wood Stove/
Solid Fuel:
Gas Water Heater (s):
11
UNIT HEATER(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:
100-50OM:
500-1000M:
14
1000-175OM:
Other:
Pressure Vessel (cu. ft.):
15
COMPRESSOR/HP: Less than 3:
3-15:
15-30:
30-W:
50+:
16
GAS PIPING SYSTEM: Number of outlets:
17
HEATING SYSTEM: 1-100,000 BTU: 7� o0
100,001 + BTU:
18
TYPE FUEL SOURCE: Electric ❑ Gas Oil ❑
Coal ❑ Wood ❑ Solar ❑
19
TYPE DISTRIBUTION: Forced Air ;
Radiant ❑ ;
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 APPLICATION
OWNER OR DATE