1986, 09-30 Permit: 00013268 Mechanical|GNATURE0F
>VVNERORAGENT
OB ADDRESS
MECHANICAL PERMIT
APPLICATION
DATE PROJECT#
TOTAL FEE
APPL: Dry 0
Ra e 0 Cas Lng
0 Cas W/H 01 Solid
Fuel 0
Fee
CAS PIPINC 113Y
STEM oantiTy
O2
Fee
PP�IC ANT:
(BTU180 K or
Les s 01 Over 100K O
Fee
FUEL SOURCE:
Electric N Cas
Y Oil N Coal N Wood N
Solar N
DISTRIBUTION;
Forced Air Y
Radian! N Heat Pomp N
Processing
Fee
FEE-
PAID BY:
IA
11
IG
NC
COUNTER APP:
PLANS EXAM:
DATE:
AFCE� 11
CENSUS TR:
JINSPECTOR:
ONE.:
IZONE
I'll
IS -1
15 1
IRS1
IMOD
SE OF PE R MIT:
DIS ADDRESS:
MECHANICAL PERMIT
APPLICATION
DATE PROJECT#
iECHANICAL
TOTAL FEE
APPL: Dry 0
Ra e 0 Cas Lng
0 Cas W/H 01 Solid
Fuel 0
Fee
CAS PIPINC 113Y
STEM oantiTy
O2
Fee
T
(BTU180 K or
Les s 01 Over 100K O
Fee
FUEL SOURCE:
Electric N Cas
Y Oil N Coal N Wood N
Solar N
DISTRIBUTION;
Forced Air Y
Radian! N Heat Pomp N
Processing
Fee
FEE-
PAID BY:
IA
11
IG
NC
COUNTER APP:
PLANS EXAM:
DATE:
iECHANICAL
TOTAL FEE
APPL: Dry 0
Ra e 0 Cas Lng
0 Cas W/H 01 Solid
Fuel 0
Fee
CAS PIPINC 113Y
STEM oantiTy
O2
Fee
T
(BTU180 K or
Les s 01 Over 100K O
Fee
FUEL SOURCE:
Electric N Cas
Y Oil N Coal N Wood N
Solar N
DISTRIBUTION;
Forced Air Y
Radian! N Heat Pomp N
Processing
Fee
'
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~"
OFFICE COPY
$33.5�
6.50
3.00
9.00
15.00
*'���8u«^'"