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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