1987, 03-16 Permit App: 87000676 FurnaceMECHANICAL PERMIT APPLICATION`.WORKSHEET
PLEASE .PRINT:AND,COMPLETE ONLY' SE4?ARTS OF, THE FORM YOUUNDERSTAND
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 ��' e• DATE S"r/�`- ,7
Project M 7 /_-76
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Owner's Name Last //:mss syn /First—, j '�/MI
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Project Address (Street
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CityD ��✓✓/��[ JJ //
State
Su 1 aallofnl�Platt Name ew
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Assessor Parcel N� ��� ��
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Block" el
Applicantnn
—23/4 A
Address
City
Stats
P.
9716".-2-2S-7 Phone
Matinees Phone
Contractor �/V
Z9/ / 1L / c�
Addreaa
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City
State 4
. 59,�
Phone
Contact
License a
,!But
Phone
Describe Work .J. Cy- ,e /.C.._— "2-1,</141—e^0
`/y{`�/Evaporative
Fans
Cooler
Hoods
Electric Furnace/I5ucta
Mlaceitaneoue
Dryer
Range •
Gas Lop'. ,'
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Unita
0-10,000 CFM
10,000 + CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
':. 101-500M
501-1,000M
•
1,001.1750M
Over 1750M ,
Compressor
0-31-4P15-3OHP
30.50HP
50+HP
Gas Piping
1-5Outlets
-
6+ Outlets
ed Heating System jl.loo.000eTu
16,400+ BTU �/.et /TJ
e71,4
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 ��' e• DATE S"r/�`- ,7