1985, 09-13 Permit App: 00007003 Mechanical Fixtures . • MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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Project# "7
Owner's N$ /� Last First MI
5 Y;7 J / '4-7 -42
Project Address(Street Name&Number)
- ,sem/ — S /- - ,Z, 2iiFT, ' 5
City �' State Subdivision/Plat Name
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Assessors Parcel# � � � Lot Block Plat#
Applicant Address
City State Zip Phone
Business Phone
Contractor Addresp 0e 4.7 —/4
City State Zip Phone
Co tact License# Busirvis Phone
C, m ,c c 4 .2.. S',-> 2._ --... re--,_2e
Describe Work �o
it' 7 // l /�e'_t .. ,; i:/.4C p v.-- 1.4.17,k-ass-/.O
Fans Evaporative Cooler Hoods Electric Furnace/Duct ?i. ' 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 10x,3 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 -6" .� APPLICATION C"N -
OWNER OR c -'
31z- 2 .DATE / " /c- g--C