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1987, 10-10 Permit App: 87003701 Furnace, Water HeaterMECHANICAL PERMIT APPLICATION WORKSIIIIEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND iso 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. F SIGNATURE O OWNER OR ' APPLICATION/, DATE Project # 370/ Owner's Name !test stMI Project Ad r s (Street Name & Nu r) 1 •L, rtl. IYYI`P N City State al) r� Subdl Isco (Plat Name \%ate: I—N—s Assessors Parce tf le7 , `/� / '1///L^/ Lot I Block / Plat Applicant , .L�q 11��-t-\.� L �V l �i�� A /� �C� ��t�v\ City-c...� Stat.�� Zip fQ`C-r3 Phone�U3CS HJr7t Business Phone Contractor %a poo. 0.3., Address City State �t Zip Phone Contact 7— �, J\r\-2 rat C - License # G icy''{.. , Gl7bcc- Business Phone t83a- 9Sa3 Describe Work n6 1"K 4\a-cem V Br5 5 it .-4a lctc-e -\- -LA icslc e aC Fans Evaporative Cooler v Hoods t Electric Furnace/Ducts Miscellaneous Dryer Range Gas Log Gas Wate Htr. Solid Fuel/ Wood Stove Air Handling Units .0.10,000 CFM - 10,000+ CFM Refrigeration Systems/ Heat Pumps (BTU) 1-100M 101-500M 501-1,000M 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 1530HP 30-50HP 50+HP Gas Piping 1-5 Outlets 6+ Outlets Gas Fired Heating System 1-100,000BTi 10..0;00+BTU 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. F SIGNATURE O OWNER OR ' APPLICATION/, DATE