1984, 08-08 Permit App: 00001641 Mechanical FixturesG
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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 ��