1985, 10-28 Permit App: 00008658 FurnaceMECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU.tNIOERSTAND
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 cori-
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.
SIGNATUiE OF /` �✓�
OWNER OR /i�!
APPLICATION
DATE
Project #
Owner's Name Last �Flrst /1 MI
Beldon . I�.R-Nr [_
Project Address (Street Name & Number)
S. 802 Pierce 5T 04206
City
Spokane
State
WA
Subdivision/ Plat Name
lt�s
ia�
Assessors Parcel if J r�, ` .•02e
`/l `/�!/
Lot
Black . (�+' a /
Plat #
Applicant
Beldon
Address
S. 802 Pierce
City
Spokane
State
WA
Zip
99206
Phone
922-8410
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 gas furnace 80,000btu's $ 2/.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
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU 6 . 0 0
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 cori-
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.
SIGNATUiE OF /` �✓�
OWNER OR /i�!
APPLICATION
DATE