HomeMy WebLinkAbout1985, 08-06 Permit App: 00007143 Furnace N.
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
Project# 7/Y
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Owner's Name Last F' t MI
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Project Address(Street Name&Number)
e . / 2-le-1, g Auf q'/;2//-,
City ‘`' State Subdivision/PI Name
Asssors Parcel# Lot Block Plat#
, s(=7) — i7 2-S r 7
Applicant Ai / ,, Address //
.0 5 -2/-7 "4
City State �J Zip ,f Phone / f/
Business Phone
Contractor - Address
'd- - -- 6-4- -- •g- C--767
City State Zip Phone 6
,
-//7 -r- 57t,_
Contact / I Liceryse# Business Phone
"yl �'-e '> . -117-a_4-- t.--c7-2- 37_ t.
Describe Work
Fans Evaporative Cooler s 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)
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 10.,L00+BTU
000
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 lG ' APPLICATION 1:47� '
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OWNER OR (-_. A. –= a •ze.../ -- DAT