1988, 09-26 Permit App: 88002981 Furnacei.' i
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MECHANICALPERMIT-APPLICATION WORKSHEET
PLEASE PRINT AND'.COMPLETE'ONLY4140SEiPARTS.O.VtlE,FORM YOU_ UNDERSTAND
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Ownm'> Nome Wt First MI
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Project Address (Street Nurse & Number)•
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Btats
Subdivision/Plat Name
Assessor! Parcel a
Lot
Bieck
Plat e
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Applicant �
Sitr cL-
Address .
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State
np. :
72--a6
Plane
_ 9.25` e/Sii
.. - - 'Business Plane
Gcnlraclor
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Add esa
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State
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' 99 5-''
Plane
53.22/7//
Contact , S S L-14 /J a
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Lice`nsea may.(
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&slnen Phone
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Gncrlbe Work RErS 0,C /case n/M-ciii__—
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Evaporative Cooler
Hoods
Electric Furnace/ Duda
Miscellaneousone
Dryer
Range
Gas Log'”
Gas Water HO.5o14
Fuel/Wood Stove
Air Handling Units
0.10,030 CFM
10,000+ CFM
Refrigeration Systems/
-real Pumps (BTU)
1400M
101-500M
501-1,000M
1,001.1750M -
Ovsi 1750M
1 Camproesor
60HP
Z/5HP
1530HP
f .
OOSOHP
r50+HP
G..a Plpino
1-5 Outlets -
.. . . ..
Sa Outlet'.
tea.-Pi.oa Heating Syalem
-)7L
1.100,OOOBTU
6/ 4 CP .3 7 b
1 Ova° a BTU
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I certify that the above Information as submitted•byme,is'true and. correct and fuer,
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
:'folate or cancel the provisions of any state of local laws -regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR APPLICATION
DATE c� z6_ 7�
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