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HomeMy WebLinkAbout1986, 09-09 Permit App: 00013049 Gas PipingMECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND 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. SIGNATUaE OF OWN ER OR_✓".1 / 4' DATE APPLICATION / / Project N Owner's Name Last First MI Pelland AL ProJert Address (Street Name & Number) a E. 8622 Valley Way City Spokane State _ WA Subdivision/Plat Name Assessors Parcell Lot Block Piet # Applicant Address City 1 State Zip ! Phone Business Phone Contractor Air Design Heating and Refrigeration, Inc. Address E. 1807 Francis City Spokane State WA Zip 99207 Phone 487-4328 Contact Barbara License M AIRDF,I-,161JW Buslnees Phone 487-4328 Deecrlbe Work Gas piping to meter $20.00 Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous Ciye Range Gas Log 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 0-3HP 3-15HP 15-30HP 30-50HP 50+11P Gas Piping 1-5 Out lets 8+ Outlets Gas Fired Heating System 1-100,000BTU 10v, 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. SIGNATUaE OF OWN ER OR_✓".1 / 4' DATE APPLICATION / /