1988, 07-07 Permit App: 88001863 FurnaceMECHANICAL PERMIT APrLICATlON'WORKSHEET
PLEASE PRINT AND COMPLETE ONLY\ j StPA�R1•,TS OF; THE FORM YOU UNDERSTAND
yey
AS
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.permlt 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�{
OWNER OR DATE �°��_$�
Project 0 / e& -._S
Owner's Nem. Last First MI
%3 i ! n .. P +�K./� 4"
Project Address (Street Name & Number) .' 1
Ai S o':`: 0/ems All' _
Cit
�a lc
State
i.. . >,4-
Subdlvlsl Plat Name
PP612`ruie- rt -/
Assessors Parcel M
,.
Lot
Block •
Plat N
Applicant
- - -
Address
C n y
State
Itii
TJp, .Pfwne
-'- . 6.
F.-78 V3 o
...
-
Business Phone
-; ontractor
8/✓ � , 2/�.L CC/ ,
Address%
A79-..
/ ' AlA79-.
Al
= ty
State `-
p,V �
Phone L`
Contact
R to S S L_(.,1 of .0 E
Llosnae 0
.�i3�+�//I/, i.37,4/7
Business Phone
a
Dosc'Ibe Work
l'ahs
Evaporative Cooler
Hoods
Electric Furnace/ ducts
Miscellaneous
Dryer
Range
Gas Log'......
Cas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0.10,000 CFM
10,000+ CFM
Refrigeration Systema/
-seal Pumps (BTU)
1-100M
101-500M
y
501-1,000M
1,001.1750M -•
Over 1750M
Cornpressor
0.3HP
3-15HP
1630HP
30-50HP
I 50+HP
Gas PIpIno
1-5 Outlets . •
- !
6+ Outlets
Gas Fired Heating System
1-100,0008TU '.1t)
,.A0+BTU
46L 47-0x a16 Q3 --7o
certify that the above Information as submitted by•me,Is'true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, Including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a.permlt does not presume to give authority to
violate or cancel the provisions of any state of local laws .regulating construction or the performance of
construction.
SIGNATURE OF APPLICATION�{
OWNER OR DATE �°��_$�