1987, 06-15 Permit App: 87001805 Pipingab
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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 thls 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 �.,(ja�` //1J APPLICATION _/S_ f
OWNER OR r/V DATE
Project H /3C�^5
-�
Owner's Name Last First ^ MI
Project Address (Street Name & Number
'n . a o 4 7 L ,CO t—,L_a%�,t-
City
i
-
State a. •
Subdivision/Plat Name
Assessors Parcell
Lot
Block
Plata
Applicant
Address
City I State I Zip
I I
Phone
Business Phone
Contractor TRANSFER, INC.Address
111.Ms 4 �O
City N. 1008 RUBY
SPOKANE, WA 99202
State
Zip
Phone
Contact (509) 3283400
License ft
Business Phone
Describe work g`w (A ./1/-'D l L
f
Fans
Evaporative Cooler 1 r
V/7Y,
Hogsts
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water 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
15-30HP .
30-50HP
50+HP
Gas Piping X / / �" a
�jG�
1-5 Outlets
5+ Outlets
Gas Fired Heating System
1-100,000BTu
10.,;100+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 thls 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 �.,(ja�` //1J APPLICATION _/S_ f
OWNER OR r/V DATE