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HomeMy WebLinkAbout9406-04.PERMIT APPLIGAT~ON !.City of Port Townsend,'Washington 98368 Phone: (20385-3000 Fax: (20n385-4290: APPLICr1NT: ~ OWNER ~ CONTRACTOR ~ OTHER: ./ COMMENTS: IRE PERMIT ~ Y"4~ " ~ SITE ADDRESS: ~// ~~S9.C'O ~P OWNER: /7R ~ ~ iP/~/ CONTRACTOR LICENSE x~En s li5 1 ~ ~ 11J t7 OWNERPHONE~ ~ ~ 1~T0. TYPE:OF E UIPM ~ RANGE i WOOD/PELLET STOVE ~ GAS FURNACE brrs's: ~ CON'vrRSIONBUR,~IER brr,i. LN1T HEATER brn is BOILER ber r: GAS PIPING EVAPORATION COOLERS br AC UNIT bruit HEAT PUMP bra's: REHEAT BOX bra's: AIR HANDLING UNIT brrr is I EXHAUST FANS RANCE HOOD (residenrial) ~ RA,~iGE HOOD (commercial) CLOTHES DRYTR INCINERATOR. DUCT ALTERATION TANKS e: -( h1G- REFRIGERATION UNIT OTHER: MECHANICAL PERMIT FEE 10.322.100.00) Mechanical Fees X10386.102.00) State Fee TOTAL •"PLICANT'S SIGNATURE:- $ a~. Balance Due ADDRESS: ,S/9 ~OS9~P0(/E EXPIRATION DATE: ~$~~ CONTRACTOR PHONE ~ .ZG~'. ~_ FiOO Fees Received by Deputy-Clerk Date Recd Receipt No. ~ Plumbing Fees State Fee TOTAL