1988, 05-10 Permit App: 88001172 Furnace MECHANICALP,ERMIT-APPLICATION:WORKSHEET
PLEASE PRINT ANDCOMPLETEONLY; ams , RTOFTHg,eORMY000NDERSTAND
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Project 11
Owner's Name Last Fiat., MI
Project Address(Street Name&Number)
> 5 / 3 nl 1.,:4 i «,rte-,ce Xa
city State Subdlvls /Plat Name �--
S� . : PP fr' /-{t-SS tD U 6 UES
Assessors Parcel 0 Lot.. : Blodt•• J Plato
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Applicant AddrMe.r
City State
,-.-_ ,,•:`'::, :: Business Phone
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Contractor
Phm
City Q Stale pr �D9/ 2/i-- • L, �///
iContact . License S Business Phone
Describe Work
RO le
IAC C Q 1 L , --64049--A1/9—COC
Fans Evaporative Cooler Hoods Electric Furnace/ducts Miscellaneous
`
DRange ' Gas Log''' Gas Water Htr. Solid Fuel/Wood Stove
0.10,000 CFM 10,000+CFM
A.ir Handling Units
Refrigeration Systems/ 1-100M ;101-500M 1501-1,000M
Heat Pumps(BTU) ,
1,001.1750M '., Over 1750M
0-3HP 3-15HP ' ' 15-30HP' 30-50HP 50+HP
Compressor
1-5 Outlets ' 5+Outlets
Gas Piping
4" I m ....--.--.---11-00,0008TL10.,, 00+NTU
.Cir*V•+Jox. 0/6 /it 3 V°S
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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. Z4,-°'
SIGNATURE OF / AATECATION .S- /0 •F,�
OWNER OR --J