1986, 10-27 Permit App: 00013958 Water HeaterMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
4 2-5a
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
Project#
► 3 95
c3
Owner's Name Last First MI
Anderson Dave
Project Address (Street Name & Number
E. 10722 Maxwell
City
Spokane
State
WA
Subdivision/Plat Name
H4'L u.)ELLS Sar3
Assessors Parcel # • 10) h ` a 4 3c-,
1 Z
Lot
Block
Plat #
Applicant
Dave Anderson
Add ess
W. 10722 Maxwell
City
Spokane
State
WA
Zip
99206
Phone
926-4399
Business Phone
Contractor
Sturm Heating, Inc.
Add ess
E. 204 Indiana
City
Spokane
State
WA
Zip
99207
Phone
325-4505
Contact
Carol
License #
STURMI* 210 QF
Business Phone
Describe Work
Install Hot water tank $25.00
Fans
Evaporative Cooler .
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Wate Htr.
6.50
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,030+ CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
'
101-500M
501-1,000M
1,001-1750M
Over 1750M
Compressor
0-3HP
3-15HP
/
15-30HP
=
30.50HP
50+HP
In
Gas Piping g
1-5 Outlets / ---o O
(3. 50) ) 3
6+ Outlets
Gas Fired Heating System -
1-100,000137U
10v,:A0+BTU
61I) + 3Oe A 2 EC
IV E i
\I1 vG(z,'E 1gB6
Z1'- -t,� �J
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