1986, 09-26 Permit: 00013292 Mechanical FixturesSIGNATURE OF
OWNER OR AGENT
.IC)R ADDRFSS
hiEXHANICAL.. i''t-.RMI
APPLICATION
DATE
PROJECT#
SEQ. 11
TE: 0911,
Diff HANT[A I . 4 I i.
FEES:PAID BY: CA CK CG NC
0 u
COUNTER APP: PLANS EXAM: DATE:
MECIIANTCAL. TOT AI... F'I-:i:
HEAT SYSTEM (BTU): 100K or I-r-..<.:si:,; 01 Over, 100K 0 P
I'UL•::I_ SOURCE: Electric Gas Y O:i.7. N Coal N Wood N Solar N
DT.8'T'R1Ei.J7-l.ON: Forced Air Y Radiant N Heat F'ump N
$24.00
9100
15,Ci'!
09-26-�6 531.82 *24;00
OFFICE COPY
OWNER
ADDRESS:
CITY: ST:
ZIP:
APPLICANT: 77
CONTRACTOR:
A o Dj(_'//xS� I I c --
A V
CITST:
�uLo*
ZIP:(f/�
!W(,
LICENSE-
ARCH/ENGINEER:
ADDRESS:
CITY: ST:
ZIP:
PARC ELR::
: /r // 0 4
CENSUS TR:
INSPECTOR:
PLAT.:
LOT 8C BLOCK
1111411-
INALPLAT
PLATNAME:
ZONE.: ZONE
FSB
S-1
S-2
RSB
MOD
USE OF PERMIT:
JOB ADDRESS:
hiEXHANICAL.. i''t-.RMI
APPLICATION
DATE
PROJECT#
SEQ. 11
TE: 0911,
Diff HANT[A I . 4 I i.
FEES:PAID BY: CA CK CG NC
0 u
COUNTER APP: PLANS EXAM: DATE:
MECIIANTCAL. TOT AI... F'I-:i:
HEAT SYSTEM (BTU): 100K or I-r-..<.:si:,; 01 Over, 100K 0 P
I'UL•::I_ SOURCE: Electric Gas Y O:i.7. N Coal N Wood N Solar N
DT.8'T'R1Ei.J7-l.ON: Forced Air Y Radiant N Heat F'ump N
$24.00
9100
15,Ci'!
09-26-�6 531.82 *24;00
OFFICE COPY