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1986, 07-01 Permit app: 00011897 Heat PumpMECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND 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 APPLICATION OWNER OR DATE Project # Owner's Name Last First MI Troske Jan Project Address (Street Name & Number) 3205 S. Robie City Spokane State WA Subdivision/ Plat Name PI 1911-N11 5- 419. . Assessors Parcel�4 1 - 2© 0 \ Lot l Block Plat /r Applicant Jan Troske Address 3205 S. Robie City Spokane State WA Zip 99206 Phone Business Phone Contractor Sturm Heating Address E. 204 Indiana City Spokane State WA Zip 99207 Phone 325-4505 Contact Carol License # STURMI* 210 QF Business Phone Describe Work Install HP $24.00 Fans 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 9.00 101-500M 501-1,000M 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 15-30HP 30-50HP 50+ HP Gas Piping 1-5 Outlets 6+ Outlets Gas Fired Heating System 1-100,000BTU 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 APPLICATION OWNER OR DATE