1986, 08-26 Permit 00012817 Heat PumpIF °
SIGNATURE OF
OWNER onAGENT
MECHANICAL PERMIT
APPLICATION
DATE -
nECHAN1CAL
[COUNTER APP: 77 PLANS DATE:
MECHANICAL
FRIDCE: 1
- 100K
01 100 - 500K O
ROBI��JRT V,
TOTAi' FEE
--1000K O Fee
1000
- 1750K
0 Over 1750K 0
Pres
Vessl 0
e
Av
-INDIANA
PH: LICENSE*:
N Solar N
DISTRIBUTION�
Forced
Air N Radiant N Heat
Pump
Y
Processing Fee
PLA-
IBLOC�
11-01
PLAT NAME:
USE OF PERMIT:
11 18 ADDRESS:
MECHANICAL PERMIT
APPLICATION
DATE -
nECHAN1CAL
[COUNTER APP: 77 PLANS DATE:
MECHANICAL
FRIDCE: 1
- 100K
01 100 - 500K O
500
TOTAi' FEE
--1000K O Fee
1000
- 1750K
0 Over 1750K 0
Pres
Vessl 0
e
FUEL SOURCE,- Ec lectr
N Cas N Oil N Coal N
Wood
N Solar N
DISTRIBUTION�
Forced
Air N Radiant N Heat
Pump
Y
Processing Fee
$24.00
9.00
15.00
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