HomeMy WebLinkAbout9405-07--
-'' PERMIT APPLICATION
City oP Port Townsend, Washington 98368 Phones (20385 3000': ~'~: '(20385-429(i'
~ ALL WORK MUST COMPLY WITH
APPPLICANT: OWNER ~ CONTRACTOR ~ OTHER: /yam// CODE
COMMENTS: tl E Lo CAT C" ~fl^c-~ ~~ 6 r^c~(~_. PERMIT # _ "/ 7~S ~ 7
SITE ADDRESS~~ ~ V" AS'N (k T`~ 1~
OWNER: 4 C-NARO ~FJ nl C- ADDRESS~9 / ~E~Itn1S iVJ E ~- Q.V~~i~
CONTRACTv^R: S ~' M~
ADDRESS: S A A'1 t`
CONTRACTOR LICENSE
OWNER-PHONE ~ ~ ~ S ~ < <~ ~ ~
NO. TYPE OF E LIIPMEN`I
RANGE
WOOD/PELLET STOVE
GAS FURNACE brrr'r:
CON'vrRSION BURDIER bruit
UN[T HEATER bra's:
BOILER bra is
GAS PIPING
EVAPORATION COOLERS bra's:
AC UNIT bra is
HEAT PUMP bruit roar
REHEAT BOX bnr is
AIR HANDLING UNIT bnri:
EXHAUST FA,~1S
RADIGE HOOD (residential)
RANGE HOOD (commcrcial)
CLOTHES DRYER
INCINERATOR
DUCT ALTERATION
TANKS e:
REFRIGERATION UNIT
OTHER:
MECHANICAL PERMIT FEE
E.YI'IRATION DATE: ^~
CONTRACTOR PHONE *t S $ S I ~l
__..
10.322.100.00) Mechanical Fees Plumbing Fees ~
)10.386.102.00) State Fee .State Fee ~'
TOTAL _ '_-D _ TOTAL
"PLICANT'S SIGNATU v'im' ~-`-` DATE:
Balance one- Fees Received by D ty-Clerk Date Recd Receipt No.