1986, 11-06 Permit App 00014045 Inspect Fireplace750
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
Project #
Owner's Name Last First MI
Darnell Everett A.
Project Address (Street Name & Number)
10822 E. Empire Way
',State
City
Spokane
Wa.
Subdivision / Plat Name
Grandview Acres
Assessors Parcel #
04541-0616
Lot
Ely 112ft.L8
Block
B 8
Plat #
Applicant
Everett A. Darnell
Address
10907 E. Empire Way
City
Spokane
State
Wa.
Zip
99206
Phone
(509) 926-5318
Business Phone
Contractor
N/A
Address
City
State
Zip
Phone
Contact
License #
Business Phone
Describe Work
Inspection request for existing fireplace and chimney
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
101-500M
501-1,000M
1,001-1750M
Over 1750M
Compressor
0-3HP
3-15HP
15-30HP
30-50HP
50+HP
Gas Piping
1-5Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10..,:00+BTU - i
` j
):t• L,-. ✓ �1i a \
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 i(' l� APPLICATION 11-3-86
OWNER OR _ ,, , d DATE