1985, 12-02 Permit App: 00008950 Insert •
• MECHANICAL PERMIT APPLICATION WORK=MEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
Project# ,"1/66
Owner's Name Last First MI
Scelfo John
Project Address(Street Name&Number)
S. 5312 Van Martin _
City State Subdivision/Plat Name
Spokane WA 99206
Assessors Parcel#
CBC)-57
BC) ) Lot Block Plat#
Applicant Address
City State Zip Phone
Business Phone
Contractor Address
Valley Fireplace 16610 E. Sprague - PO Box 553
City State r Zip Phone
Veradale WA 99037 922-2780
Contact License# Business Phone
v , /
ALL ,F 177 CG
s pDescribe Work1 i
Lopi .lush /,C; Q t'''-'!-"I'..
Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous
Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove
yPS2 SPP abr)VP
0-10,000 CFM 10,000+CFM
Air Handling Units
Refrigeration Systems/ ' 1-100M 101-500M 501-1,000M
Heat Pumps(BTU)
1,001-1750M Over 1750M
0-3HP 3-15HP 15-30H P 30-50H P 50+H P
Compressor
1-5 Outlets 6+Outlets
Gas Piping
Gas Fired Heating System 1-100,000BTU 1Q,,;,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. /
i� /
SIGNATURE OF 11 i APPLICATION f i (" /% �`�
OWNER OR .ji V-V,''-' � 41, . ,41 .DATE os `) 1