HomeMy WebLinkAbout1986, 07-07 Permit App: 00011973 Heat Pump - MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
As
Project# 11.9-7-3
Owner's Name Last First MI
Jurgensen Grant
Project Address(Street Name&Number)
S. 1318 Timberlane Kt]
City State Subdivision/Plat Name
Veradale WA -?-0f-1 ?
Assessors Parcel# __(,151/-.3- Of/
_�/V Lot Block Plat#
Applicant Address
Grant Jurensen S. 1318 Timberlane
City State Zip Phone
Veradale WA 99037 924-6064
Business Phone
Contractor Address
Sturm Heating, Inc. E. 204 Indiana
City State Zip Phone
Spokane WA 99204 325-4505
Contact License# Business Phone
Carol STURMI*210 QF
Describe Work
Install HP 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
1-5 Outlets 6+Outlets
Gas Piping
Gas Fired Heating System 1-100,000BTU 10o0300+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