1987, 09-21 Permit App: 87003145 Mechanical Fixtures MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) ,--22/jEjrst) (M) Department Use Only
�` 7—L'-E)/O Project No.
2 Project Address(Not Mailing Address) Space
Zip
& ' 97 '94— 6-. /.2rgL.A/ 17 q
3 City/Community State Subdivision/Plat Name
79()fr("gV //G!,ei ,',11\1(iiMl l(ivr, 1-1.
4 Assessor Parcel No. 1 Lot Block
1,6„.„..919tr for Firm Name ______y___ 4{ e366a
--- ::;� Street Address i
17 Zip City State Phone�� �
18 Contact Person' — /-7,,/,.-- (NC%1 ) 9-4e-,g,-, 6----'2---
License No. Phone if different than above
8 Owner/Agent(if different than#1 above) I Business Address a
L____9 Zip City State Phone
( )
15 Describe Work:
New 0 Addition/Alteration ❑ Replace/Repair
10 Applicant Name I Street Address
11 Zip City State Phone
( )r
8 VENT: Fan(s): Evap Cooler(s): Hoods
( ) Duct(s)1: Miscellaneous: ,r _
1.
10 APPLIANCE: J 1
Wood Stove/ S
_-----
Dryer(s): Range(s): Gas Lo s
9O Solid Fuel: Gas Water Heater(s): 8 C.sp
H 11 UNIT HEATER(S): Wall Mount: Y N I Floor: Y N
Z Suspended: Y N
W
a 12 AIR HANDLING: 10,000 CFM or less: More than 10,000 CFM:
5
0
W 13 REFRIG SYSTEM BTU: 1-100M: 100-500M: 500-t 000M:
u_
0
W 14 1000-1750M: Other:
Pressure Vessel(cu.ft.):
1—>-
,
O 15 COMPRESSOR/HP: Less than 3:
Z 3-15: 15-30: 30-50: 50+
Q
G D'A.,PiPit4G SYSTEM:Number of outlets: c / �, s
W �/ ,
w
D 17 HEATING SYSTEM:1-100,000 BTU: , /� O-
Z ( 100,001+ BTU:
18 TYPE FUEL SOURCE: Electric 0 ; Gas Nr; Oil ❑ ; Coal ❑ ; Wood 0 ;
Solar 0
19 TYPE DISTRIBUTION: Forced Air ❑ ; Radiant 0 ; Heat Pump 173
1* Number of separate zones for any heating, A/C or air handling 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 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 '"s DMSO oftemeN or ALLIED HEAT,iNC APPLICATION
OWNER OR E. i41 TRENT AVE. DATE 9A1/42
SPOKANE,WA 99206
928-8252
• i 1-.
' ,
n'l -,),\I, %.14-oV(\1- 111
450'
1doitm
0
\