1984, 07-26 Permit App: 00001479 Heat Pump County permit
•
• MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) (First) (M) Department Use Only
Glass Dennis Project No. '7
2 Prti,eft Addn U O Mai lTg,gdQress) Space Zip
99206
3 City/Community t5 4�C1 State Subdivision/Plat Name
Spokane WA 11/I'yets, T, P/
4 Assessor Parcel No. / Lot Block
2O5 et &
16 Contractor Firm Name Street Address
Sturm Heating E. 204 Indiana
17 Zip 99207 cspokane State
WA Phone
(509 ) 325-4505
18 Contact Person License No. Phone if different than above
Diane ST-UR-MI-210-QF same
8 Owner/Agent(if different than#1 above) Business Address
same
9 Zip City State Phone
( )
15 DescribeWork:Install Heat Pump
New ❑ Addition/Alteration Replace/Repair ❑
10 Applicant Name 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): Range(s): Gas Log(s): Solid Fuel: Gas Water Heater(s):
H 11 UNIT HEATER(S): Wall Mount: Y N Floor: Y N Suspended: Y N
W
a12 AIR HANDLING: 10,000 CFM or less: More than 10,000 CFM:
5
W 13 REFRIG SYSTEM BTU: 1-100M: 100-500M: 500-1000M:
LL
0
14 1000-1750M: Other: Pressure Vessel(cu.ft.):
a
>-
I—
15 COMPRESSOR/HP: Lessthan3: 3-15: 15-30: 30-50: 50+:
W 16 GAS PIPING SYSTEM:Number of outlets:
m
2
17 HEATING SYSTEM:1-100,000 BTU: 100,001+ BTU:
Z
18 TYPE FUEL SOURCE: Electric ❑ ; Gas ❑ ; Oil ❑ ; Coal ❑ ; Wood ❑ ; Solar 0
19 TYPE DISTRIBUTION: Forced Air ❑ ; Radiant ❑ ; Heat PumpOc
1* Number of separate zones for any heating, A/C or air handling system. fee $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 - APPLICATION
OWNER OR DATE oS