1985, 11-15 Permit App: 00008727 Furnace A.- ' t
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MECHANICAL PERMIT APPLICATION WORK$HMIT
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
Project# 0'1 2 7
Owner's Name Last First MI /
Project Address(Street Name&Number)
/7 7 c ' / '1 P415Ze
CityState Subdivision/Plat Name
1714:41 017•e it/ia5X
AUessors Parcel# Lot Block Plat#
Applicant Address
City State Zip Phone
Business Phone
Contractor Address
tivLcAI /v 1/4.7 ,n C2 9 . -3 ATE iu
City State Zip Phone
Contact License# Businp4 Phone
!/vI.e,F'A/ /sic) N)tJ /—/ 0V ea•'g
Describe Work _
2T' v 57;0, 9 T cJ en,A C t 4 .77i c-1 kut9e'4-
Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous
Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove
0-10,000 CFM 10,000+CFM
Air Handling Units
Refrigeration Systems/ 1-100M 101-500M 501-1,000M
Heat Pumps(BTU)
1,001-1750M Over 1750M
0-3HP 3-15HP 15-30H P 30-50H P 50+HP
Compressor
1-5 Outlets 6+Outlets
Gas Piping E!j— �,.---
1-100,000BTU 10.,Z.00+BTU
Gas Fired Heating System 1.------- o/''
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 provisi of any state of local laws regulating construction or the performance of
construction.
SIGNATURE OFAPPLICATION
OWNER OR r .` . . ‘1,1 .DATE // -- %.S'--- 4P—C