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1991, 09-19 Permit App: 91006068 Furnace, Pipingq'l-C .� . rwtumusitau. rtnnnii Arruwm:fun runai ', Information, W: rksheet x JOB STREET ADDRESS: C7 CITY/STATE/ZIP: -74/).„2_ 3 G PARCET NUMBER: O ` �� -.0 ? � -- PHONE NUMBER: ' .. MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: i4rCZ�tm S `'x"`171 AAA NUMBER: ( VO '� Z PHONE NUMBER: q 2_12— & ) 0 MAILING ADDRESS: (Street) • (C y/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION (Zip) =AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (1 - 4 OUTLETS) GAS PILING (5 OR MORE. EACH:) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE)_ UNLISTED GAS APPLIANCE <400,000 BTU _ UNLISTED GAS APPLIANCE >400,000 BTU _ USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS OR 12' PTN. OF HOOD) t x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 4.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 =. x 50.00 - x100 . $ - x12.,00r x 15.04.= e