1987, 03-05 Permit App: 87000544 ACMECHANICAL 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 this type of work, including inspection requirements, will be com-
piled 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
ltADJFQ (10
APPLICATION
11. rr
55
Holm 1 2.
Owrlr'. Nrn. Wt Flnl ee, MI
Project Address (Sitar Name a Number)
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Subdivision/ Rat Name
6011-Itit5 Oh '0 ° R
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10,000 ♦ CFM
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1.10;61 /
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101.60061
301.1,000.4
1,001.175061
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1.1m,0000TU
100AXI • 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-
piled 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
ltADJFQ (10
APPLICATION
11. rr
55