1986, 11-14 Permit App 00014257 FurnaceMECHANICAL PERMIT F:PPUCATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLYTHyQSElPARTS OF 0!; FORM YOU.,UNDERSTAND
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certify that the above Information as submitted by me is true'and correct and further, agree Molt all )JI V -
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: reg ulating construction or the performance of
construction.
/�j/ // APPLICATION
SIGNATURE OF '/%f /'G��� DATE
OWNER OR_� ,
Pro)ecl $ t
..__Leal First Mi
p npra Name G�%GL ✓ �z
Proj Odl Address (Street Name 3 Number)
State
Subdivlalon/Plat Name
Ax eeaprs Parcel M
L
1116/ D c
'Lot Block Plat M
Applicant
Address
city State ao:
Pn°^°�_�z97
>f'�
:AdBusiness
Phone
contractor
SDP`•"' -
Address,y�n
State
'uyBualnel
Phone
i
GOntdct
Mone
Caacrlbe work
Fpn9 Evaporative Cooler Hood$ Electric Furneoe/Duda Mlscellsrleow
LDryer Range Gas Log"_' Pea water Htr. Solid Fuel/wood Stwe
-
0-10,000 CFM
10,000+CFM
i Air Handling Unite
r Pn vlgeralid Systemal
1.100M
101 -SOON
501-1,000M
Pumps (B
(BTU)
1,001-t 750M
Over 1750M
0-3Hp
315HP
1S3,
30-SOHP
SO+HP
;gmproeeor
-
1.5 Outlets
6+Oullets
Gas Piping
tOv,:.00+BTU
C,as Fired Heating System
i-t00,0008TU
1-1-00,=M
I /
Via!
certify that the above Information as submitted by me is true'and correct and further, agree Molt all )JI V -
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: reg ulating construction or the performance of
construction.
/�j/ // APPLICATION
SIGNATURE OF '/%f /'G��� DATE
OWNER OR_� ,