HomeMy WebLinkAbout1986, 06-02 Permit App: 00011673 Heat Pump MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
41065
Project#
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Owner's Name Last Fisst MI
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Project Address(Street Name& mbar)
Cit tate Subdivision/Plat Name
Assessors Parcel# Lot Block Plat#
'65
Applicant Address
City State Zip Phone
Business Phone
Contractor Tm
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City : -- State , j /v` Phi G/Contact ��fLicense#
Business Phone
Describe Wor '' /� M e. .?Y//
Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous
Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove
0-10,000CFM 10,000+CFM
Air Handling Units
Refrigeration Systems/ 1-100M 101-500M 501-1,000M
Heat Pumps(BTU)
1,001-1750M Over 1750M
Compressor 0-3HP 3-15HP 1530HP 3050HP 50+HP
1-5 Outlets 6+Outlets
Gas Piping
Gas Fired Heating System 1-100,000BTU 10k,,:.00+BTU
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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 0 APPLICATION
OWNER OR - ¢ � � .DATE 7,22/ 6---