HomeMy WebLinkAboutAPPLICATION - 08-00473 - 629 Countryside Ave - MedeirosSep 29 08 03:40p Myron Creager Q
Aug 09 05 09:53a # . 004 f -7
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Please complete the entire Application'. 629 Countryside Ave - Medeiros
applicable
NAME C,, t I
PROPERTY ADDRESS( Zq r'„r,►,iT r,.� s. dL A ✓Z C.0 -Z'77- Permit#
SUBDIVISION
Required!!! MECHANICAL
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Mechanical Contractor's Name: ���1� , � _ ,`r� �usiness Name: ,,r
Address L mti -A t, CitY - - Lc, � ( �,� &ate 1� Zip ?3 j� L
Contact Phone: ( ) , 23 — lqs r( Business Phone:
Email Fax
Mechanical Estimate S (Commercial/Multi Family Ord--)
FIXTURES & APPLMNCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
5_ Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Similar fixtures or Appliances
— K Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
4 Signature ensed Contractor License number Date
Rcvred!
The City offe=huwg s perm it fee schedrde is the some as required by the State of /daho