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1985, 12-18 Permit App: 00009302 Furnace v . w MECHANICAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND Project# Owner's Na a Last First MI Becstrom Steve Projec140egs(SSeet NWarren r) City Veradale State WA Subdivision/Plat Name Assessors Parcel# Lot Block Plat# Applicant Address Beckstrom 1403 S. Warren City State Zip Phone Veradale WA 99037 924-1223 Business Phone Contractor Address Sturm Heating, INC. E. 204 Indiana City State Zip Phone Spokane WA 99207 325-4505 ContactLicense# Business Phone Diane ST—UR—MI-210—QF 325-4505 Describe Work Install 15KW electric furnace Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous 3.00 4. 50 Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove 0-10,000CFM 10,000+CFM Air Handling Units Refrigeration Systems/ 1-100M 101-500M 501-1,000M Heat Pumps(BTU) • 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 15-30H P 30-50H P 50+H P 1-5 Outlets 6+Outlets Gas Piping Gas Fired Heating System 1-100,000BTU 10.,:,00+BTU total $ 20 .00 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 `7F �-, �; _ APPLICATION , OWNER OR /�/ `'c ' ' DATE %4.-—/r'�'S