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1986, 06-04 Permit App: 00011381 Furnace, AC , f A MECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND i As /L Project# 1138/ Owner's Name Last First MI Doyl Ken-rC rN C Project Address(Street Name&Number) E. 10404 Sharp City State Subdivis' /Plat Name Spokane WA PP [LT-3 Po 1S`T' Assessors Parcel# /75111 - 022Lot Block Plat# Applicant Address Ken Doyl E. 10404 Sharp City State Zip Phone Spokane Wa 99206 924-4287 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 A/C and Gas furnace $33.00 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/ 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 1-5 Outlets 6+Outlets Gas Piping 1-100,000BTU 10v,,;00+BTU Gas Fired Heating System 9 .00 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