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1986, 10-13 Permit App: 00013584 Mechanical Fixtures . r ,..., - 7 ., , . . MECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND Project# Owner's Name Last First MI Fredrick Al Project Address(Street Name&Number) E. 17909 Riverway City State Subdivision/Plat Name Green Acres WA Assessors Parcel# Lot Block Plat# Applicant Address Al Fredrick E. 17909 Riverway City State Zip Phone Green Acres WA 99016 926-5198 Business Phone Contractor Address Sturm Heating, Inc. E. 204 Indiana City State Zip Phone - Spokane WA 99207 325-4505 Contact License# Business Phone Carol STURMI*210 QF Describe Work Install Air Handler 24 .00 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) 9 .00 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 10x,;,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