1986, 03-31 Permit App: 00010305 Furnace, Heat Pump1—
Z
W
0-
a
5
Lu
W
0
O
W
0-
F
0
Z
ar
2
W
m
2
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last (Flryg (M)
,...5_2l.4
Department Use Only/ y1
Project No.
2 Project dress (Not Mailing ess) Space Zip
e
• // / oc- n Q "--, / q 9,46 cc
3 City/Community
State
Subdivision/Plat Name
4 Assessor Parcel No
Lot
1 Block
16 Contractor Firm Name
1 -� 1 --
�%
Str: 4 Address
°-
17 Zip 1
9 9 d -o co
City
e.,-„..•-_$—
State
Cie—
Phone
( ) Fd --r- FIL.S.--
18 Contact Person
License No.
Phone If Oil ferent than above
6 Owner/Anent (if different than Mt. • ova)
et _,; y r
I Business
/J.
Address r
.3„L lc, 1/l � Ire.. ie-
9 Zip Ity
9sa0co
State
Phone
( )
15 Describe Work.
New V Addition/Alteration ❑
Replace/Repair, 0
10 Applicant Name /Street
(}�jb
Address
11 Zip
City
State
Phone
.1 )
-8 VENT: Fan$):
Evap Cooler(s):
Hood(s):
Duct(s) 1:
Miscellaneous:
10 APPLIANCE:
Dryer(s)' 1
Range s):
Gas Log(s):
Wood Stove/
Solid Fuel:
Gas Water Heater(s):
11 UNIT HEATER(S): Wall Mount: V N
Floo : Y N
Suspended: Y N
12 AIR HANDLING' 10:000 CFM or less:
More than 10.000CFM:
13 REFRIG SYSTEM BTU: 1-100M: "l
40, 000
100-500M:
500-1000M:
14 1000-1750M:
Other:
Pressure Vessel (cu. ft):
I15 COMPRESSOR/HP: Less than
3-15:
15-30: 30-50:
1
16 GAS PIPING SYSTEM: Number of outlets:
17 HEATING SYSTEM: 1-100,000 BTU: 75
j C 60 0 Lk/
al %
/
Imam+ BTU:
18 TYPE FUEL SOURCE: Electric 0 ; Gas X Ott 0 ; Coe 0 ; Wood 0 ; Solar 0
19 TYPE DISTRIBUTION: Forced Alr Radiant 0 ; Heat Pum
1' Number of separate zones for any heating, A/C or air handling system.
3,3
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.
ALDENDORF FURNACE
SIGNATURE OF'A toNOrALLIED HEATING, INC APPLICATION
OWNER ORc.93b1 TRENT AVE. DATE 4-.fir—FF
SPOKANE, WA 99 »