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1985, 10-08 Permit App: 00008659 Furnace, PipingMECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND /6,6105 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 OWNER OR APPLICATION d DATE Project # 1, (�i Owner's Name Last First MI Caldwell Dick Project Address (Street Name & Number) N. 4406 Progress Q. (6, City Spokane State WA Subdivision/ Plat Name fqttictcsA o' Assessors Parcel #Lot C254/t- c2t1 .7 Block Plat # Applicant same Address same City Spokane State WA Zip 99216 Phone 928-2939 or 456-2718 Business Phone Contractor Sturm Htg. Address E. 204 Indiana City Spokane State WA Zip 99207 Phone 325-4505 Contact Diane License # ST—UR—MI-210—QF Business Phone 325-4505 Describe Work Install new gas furnace 52,000btu's $ 20.00 Fans 3.00 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 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 15-30HP 30-50HP 50+HP Gas Piping 2.00 •00 1-5Outlets 6+ Outlets Gas Fired Heating System 1 100'000BTU 6.00 .00 10v,:.00+ 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- 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 OWNER OR APPLICATION d DATE