1986, 12-09 Permit App: 00014474 Furnace, Piping MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
Project rf I/4h jh it
Owner's Name Last First MI
WARNER KIM
Project Address(Street Name&Number) •
13403 E_13th
City State Subdivision/Flat Name
SPOKANE WA
Assessors Parcel 0 Lot Block Plato
Applicant Address •
City ( State Zip Phone
Business Phone
_Contractor Address
AIR DISGN _ E 1307 FRANCIS
GSt KANE State WA ZIpPho99207 ne 487-4328
Contact License 0 Business Phone
BARBARA -AI /U*1610W _ 487-4328
• Describe Work •
INSTALL 60,000 BTU GAS FURNACE
Fans . Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous
Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove
0-10,000 CFM 10,000+CFM
Air Handling Units '
Refrigeration Systems/ 1-100M 101-500M 501-1,000M
Heat Pumps(BTU)
1,001-1750M Over 1750M
•
CompressorO-3HP 3-15HP I 15-30HP 30-50HP 50+HP
1-6 Outlets 8+Outlets
Gas Piping •
• 1_gas outlet
Gas Fired Heating System 1-100,000BTU 1Qv,:AO+BTU
60,000 BTU
•
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 ; .APPLICATION
/ �
OWNER OR -' '�a ,'/i mow / DATE