1987, 08-19 Permit App: 87002719 AC U �2y0
MECHANICAL PERMITAPPLICATION:WORKSHEET
PLEASE PRINT AND COM PLETE ONLY S F. ` RTSOF TH0,FORM YOU UNDERSTAND
Hso
IP015ct# J7-271Q
Owner's Name Last Q [First • MI
Chp C
Project Address(Street Name&Number) :'�``�`. .•
3 7/ r v
Cry Stats Subdivision/Plat Nartip
SPOkA-VaC, w
Assessors Parcel N 2_2,5 1q5 Lot m Blodc Piet
Applicant •
- - Address
City State q cep, phone
,Sf o cry'-1U/' GO,f} , `1. 6 • `l Z 6 YY 6
Business Phone
Contractor
Adana
17/91�� a
City .-. State �� �P/ 7/�T/f—' �e ��✓- �/��
Contact License 0 Business Phone
✓Off s/
////7-4/11/4,A1/
Describe Work
. ids 7,4-4.4.- W6 Ar, C-119.01/4/d
Fans Evaporative Cooler Hoods Electric Furnace/ducts Miscellaneous
Dryer Range Gas Log,s' Gas Water Htr. Solid Fuel/Wood Stove
0-10,000 CFM 10,100+CFM
Air Handling Units
Refrigeration Systems/ 1-100M .101.-500M 501-1,OOOM
Meat Pumps(BTU)
1,001-1750M Over 1750M
0-3HP 3-I5HP 15-3OHP 30.50HP 50+HP
Compressor e2 70A/
I_
V 1-5Outlab 6+Outlets
Gas Piping
1-100,0008TU - • 10...,J00+BTU
Gas Fired Heating System
•
•
l �
wirf vY.
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 nnt. 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 / —d7
OWNER OR �� � ( DATE �:_