1986, 11-05 Permit: 00014017 Wood Stove � ' ' _
SIGNATURE OF fit.- APPLICATION
OvVNER0RAGENT ° ' zt ��' /' DATE
JOB ADDRESS Y PROJECT#
, .
DATE:
14402 E �� �� AV TOT
'5571 ' 00014017
OWNER:
UE/ LEh R MECHANICAL $25 . 00
"7 ""2 E 12TH AV
"'��'R ADALE "`'WA 99037
nim, CARPENTRY
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77A7C"' ARpENTRY
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ANE =WA ="'99205
.
' DRAM**164MT
ST:
PJ"""=` 1704 CENSUS T '099900
;23543
~^T.`54400 LOT& BLOCK0D2003 023
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WOODSTOVE
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'"" ^"=E""' """°`""^""Y "="""`^°' DATE
�4402 E 12TH AV /
MECHANICAL PERMIT
MECHANICAL. TOTAL FEE $25 , 00 P,
APPL : Dry 0 Range 0 Gas Log 0 Cas W/H 8 Solid Fuel 01 Fee 10 . 00
1 FUEL SOURCE ; Electric N Cas N Oil N Coal N Wood Y Solar N
$
DISTRIBUTION : Forced Air N Radiant Y Heat Pomp N
Processing Fee 15 . 00
11705 -86 617. 8u * 2 500 �
OFFICE COPY
OB E
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