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2013, 08-29 Permit: BLD-2013-1730 Furnace Install• Permit Center n 11703 R Sprague Ave, Suite B-3 Spokane Valley, WA 99206 J ley (509)6118-0036 FAX: (509)688-0037 Community DevNopmenl peltO@t11�1f snokaucvalleLorg Mechanical Permit Application C SITE ADDRESS: FName: lding Own CA Phone; PERMIT NUMBER: PERMIT FEE: t• Commercial [Residential Fax; AND EX 0 I- 10 np— Ivv.vvl Sua —30 hp - 600,001 t0 t 0 hp — 1,000,001 10 117 ar Rn hn — nvar 1.750.1 BTU ust YY vV V o I V Y c O, O I —1- vn CC O I nIY V IIYl.1 EXPIRE9: VIN: ©CABti ❑ CHECK ❑ VISA ❑ MC CARD k: SIGNATURE P:1Community Developmen1\02 Administration\03 Forms - Official VersionsU'crmil CcnIrAMeailtanical Permit Application 04-03-09 dg.doc 11� Address: City: State: Contractor rJ Na;;: �1��� i Tne, Phone;� • Y: IPOs !J� (o 15 Address;It License No: ��' City: Q Cily Win l.ic: State; U_ -) Zip; ' Cu4tbct/J11VjOcl Managortjs Name: &,r) n Pl g'� .�.�•1s -5 of) to phone: IG2 O'-1 - Z. Z -2i2— AND EX 0 I- 10 np— Ivv.vvl Sua —30 hp - 600,001 t0 t 0 hp — 1,000,001 10 117 ar Rn hn — nvar 1.750.1 BTU ust YY vV V o I V Y c O, O I —1- vn CC O I nIY V IIYl.1 EXPIRE9: VIN: ©CABti ❑ CHECK ❑ VISA ❑ MC CARD k: SIGNATURE P:1Community Developmen1\02 Administration\03 Forms - Official VersionsU'crmil CcnIrAMeailtanical Permit Application 04-03-09 dg.doc 11�