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1984, 08-08 Permit App: 00001641 Mechanical FixturesG 2 a 0 0 w 0 0 w a 1- 0 Z cc w 0 i D Z MECHANICAL PERMIT APPLICATION WORKSHEET 23.5° PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND 1 Owner's Name (Last) (First) (M) Peterson, Paul A. Department Use Only 1 / Protect No I LP I 2 Project Address (Not Mailing Address) Space S. 1623 Pines Rd., 9986 3 City/Community Spokane, State Wash. Subdivision/ Plat Name 4 Assessor Parcel No. L1 17— Ir,73 Lot Block 16 Contractor Firm Name Alpha Services Street Address P. 0. Box 5659 17 Zip 99205 City Spokane, state WA Phone ( 509) 467-0684 18 Contact Person Larry Miller License No. ALPHAS 1840T Phone if different than above 8 Owner/Agent (if different than 01 above) Business Address 9 Zip City - State Phone ( ) 15 Describe Work. New 0 Addition/A teration DX Replace/Repair ❑ 10 Applicant Name Peterson, Paul A. Street Address S. 1623 Pines Rd. 11 Zip 99206 City Spokane, State WA Phone (509)922-7680 8 VENT' Fan(s): Evap Cooler(s): Hood(s)' Duct(s) 1 Miscellaneous. 10 APPLIANCE: Dryer(s): Range s): I Gas Log(s)' Wood Stove/ Solid Fuel: Gas Water Heater(s): 11 UNITHEATER(S)' Wall Mount. Y N Floor' Y N Suspended: Y N 12 AIR HANDLING: 10,000 CFM or less: More than 10,000 CFM. 13 REFRIG SYSTEM BTU: 1-100M: 100-500M' 500-1000M: 14 1000-1750M. Other: Pressure Vessel (cu. t.)• 15 COMPRESSOR/HP: Less than 3: 3-15: 15-30: 30-50: 50+: 16 GAS PIPING SYSTEM' Number of outlets: 17 HEATING SYSTEM' 1-100,000 BTU 100,001+BTU: 108,000 18 TYPE FUEL SOURCE: Electric 0 , Gas l$; OH 0 , Coa 0 ; Wood 0 ; Solar 0 19 TYPE DISTRIBUTION. Forced Air I -'C ; Radiant 0 ; Heat Pump❑ 1* Number of separate zones for any heating, A/C or air handling system. 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 £:::: % 2 M6L)—) OWNER OR �Ly .' (� (off APPLICATION J DATE (�/ S ��