1985, 10-09 Permit App: 00008436 Furnace ` MECHANICAL PERMIT APPLICATION WORKSHEET
I,,, PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last)40 •
(First) (M) I Department Use Only •
i Jt
2 Project Ad ress(Not Mailing Address)
• ��-- ., Project No.
1q
Space Zip
Y ci
3 City/Community Sta Subdivision/Plat Name / � �
4 Assessor Parcel No. I Lu`�- PCAJDE PCSA /�1C 17 S m
LotI Block I
16 Contractor Firm Name
L-
I StreetAddress
f �
Zip City State q i'�
17 "--ti—
Phone
I >d1".) 0..._),,," ( ) a'if -cf -S L-
18 Contact Person License No.
Phone If different than above
8 Owner/Agent(if different than#1 above)
�.�...�...
C r _ 6-y .441 Business Address
9 Zip /I City State I Phone
15 Describe Work: I ( )
New 0 Addition/Alteration 0
Replace/Repair
10 Applicant Name
I Street Address
11 Zip City
State Phone
8 VENT: Fan(s): Evap Cooler(s):
Hood(s): Duct(s)1: Miscellaneous:
10 APPLIANCE:
Wood Stove/
Dryer(s): I Range(s): {Gas Lo
IIII g(s) Solid Fuel: Gas Water Heater(s):
I— 11 UNITHEATER(S): Wall Mount: Y N
W Floor: Y N I Suspended: Y N
a 12 AIR HANDLING: 10,000 CFM or less:
More than 10,000 CFM:
0
w 13 REFRIG SYSTEM BTU: 1-100M:
ti_ 100 500M: 500-1000M:
O,
w
a 14 1000-1750M: Other:
Pressure Vessel(cu.ft.):
I-
• 15 COMPRESSOR/HP: Less than 3: 13 15: 15-30: 130-50; 150+:
Z
Q
is 16 GAS PIPING SYSTEM:Number of outlets:
m
L
D 17 HEATING SYSTEM:1-100,000 BTU: //
Z /0e) n c�c� I 100,001+BTU:
18 TYPE FUEL SOURCE: Electric 0 Oil 0 ;
\ /GasCoal 0 Wood 0 Solar 0
19 TYPE DISTRIBUTION: Forced AIr )�J ; Radiant 0 ;
/\ Heat Pump
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.
,q,„.1-id4NDORF FURN AcE
SIGNATURE OF f+ ;.11441 OF Ai.UE®HEATKAy APPLICATION
,.
OWNER OR 031 • Ay, DATE /o - %'- d-,j
:iPOKANE,WA 99204