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HomeMy WebLinkAbout1988, 07-27 Permit App: 88002150 Mechanical FixturesMECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND AS5 17r 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 - Kir Project # Owner's Name Last First i MI ly ,4LLJil t= L � Project Address (Street Name & Nu ) 5d. /gam Gl.(.'O J 11 sd/f,t4 -I _ State / 410- 9�� �v Subdi ly slop/ Plat Name mOcarrok(U Vui Bev Assessors ParcelM '/ 1 1 1 Lot Block Plat ft Applicant ai/.a7L7 1{x`/07//l//o A.c Addressb�, G 3! S iv, XO Ai P0. 43.A. i/0 l-- ty State if Si470•eiG a)f- Zip 9.1-// Phone " S 3 S--% - 9 57.17 Business Phone Contractor ���/ /�T✓ S / A Alit/" Y ,4 -C . Addressee . 3s e As/ k 0..4 .R. o .G. , X // 1 2 -- City 5,o�.c7E - Zip .91�// Phone _ 3 STh - 9 -7 Contact lf`S lit i?/sC -�/jt7""lid License N / 417 (( Business Phone .f-r� Ded rlbe W n / -7- i s7"" ,e_ &L z44,41 -7,e ---- Fans Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove Air Handling Units „,_0-10,000CFM 10,000+ CFM Refrigeration Systems/ Heat Pumps (BTU) 1-100M 101-500M 501-1,000M 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 15-30HP 30-50HP 50+HP Gas Piping 1-5 Outlets �// S+ 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 - Kir