1987, 05-08 Permit App: 87001321 Furnace MECHANICAII: PERMITAPPLICATION`.WORKSHEET
PLEASE PRINT AND COMPLETE ONLY\T�OSET
PARS OF,TF-fE,FORM YOU:UNDERSTAND
Project N 1;;,7--1324
Owner's Name Last MI
ele#7/E ti-4--dite/ '
Project Address(Street Name 6,IJumber) `
4V�/4 /V f//sT '
Oily State Subdivision/Plat Name
-- N04-- P
Block Plat N
Assessors Parcel N o / (to7
/f/f (� Address
Applicant / , /
City J Vats 2/2 Ph°ne 9.2 '-7
.2 '-7 !/ 7
I I '.. r, Business Phone
ContractorAddress '
City State 'ZiC`- Phone
a/Q W/4( /�r. /j7-Vt1 . ,.._4----3,_47-17//
Contact Business Phone
/ [�,/ ///,77////,4/f License N'/,,/ ,C� /��y'/4//
Describe Work
/4e. e9/ " , " ( 2
Fans (N Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous
Dryer Range . Gas Log'':
Gas Water Htr. Solid Fuel/Wood Stove
o-10,000 CFM 10,000+CFM
Air Handling Until
Refrigeration Systems/ 1-100M ' 101-500M
501.1,000M
Heat Pumps(BTU)
1,001-1750M -- Over 1750M
0-3HP 315HP 1530HP I 3050HP 50+HP
Compressor
-- 1-5 Outlets .. 6+Outlets
Gas Piping
•
ed Heating System /
. 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 thls: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 ' , / APPLICATION ^---
OWNER OR .DATE - - —48-'952______.
. . r,, 4