1988, 09-19 Permit App: 88002807 FurnaceMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
A s
ails3 e,y e'l
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
!Ie0
Project N L-7
`//
Owner's Name Last First MI
Project Address (Street Name 8 Number
k• OLO° / .A%/"Ch_._.
City
(5, x � e—
State
1,t) A
Su on/Plat Name
" a crA
? PAet
Assessors Parcel N
075'/3— /1/2- ,a
Lot
Bleck
Plat II
Applicant -
Address
City
State
Zip
Phone
Business Phone
Contractor
-rt.' / 1JA// /f D/ //1 e, ]/ '/ N 7
Address
r,C & c O /A✓ ,c d
City
S/2D/la/1-Q-
State J
w /t
Zip
79'20 e
Phone
i/69- 9006
Contact.
7��'
K, Cant &a A
License p
r I U -C p27 -/s3 kn11
Business Phone
1/67-Yoo6
Describe Work n
/YeP/ac a 6e/P3 ' farnia oe-
Fans -
Evaporative Cooler.
Hoods
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
1,001-17,50M
Over 1750M
Compressor
0-3HP
3-15HP
15-30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU q22
10u,GW+BTU
00
1 Oc
2`f
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