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1994, 09-06 Permit App: 94008629 Water Heater
Irfo: for. Worksheet JOB STREET ADDRESS:___ e- /2-7 2 Z 6 (I Thi ! ? / 6� CITY/ STATE/ZIP: Jr C) --- W_216', PARCEL NUMBER: ©WNER: ®iii? ( PHONE NUMBER: 92- MAILING ADDRESS: _' �� 43 43dJL (Stye t) / (City/~tate) (Zi;) 300-) f t t:filliiti � LICENSE NUMBER: ©61/00 SP / 8'3 I l CONTE.ACTOR: tJ_�---- _ _ - / --- PHONE NUMBER: , (-tI & q - tP y i Q MAILING ADDRESS:_ )v 14 (Street) maimmummemmummimmosommammirmomminimummmium MECHANICAL WJR E EET/FEE SCHEDULE NUMEZF. 1 X EACH CF UNITS 1 IMIT 7, i2 __ak J CiM 992oz (City/State) (Zip) DESCRIPTION C CT. CPK SYSTEM_ CODSTC yE / INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 HEATING EQUIPMENT -,100, 000 GAS PIPING (1 --4 OUTLETS) _ GAS PIRINc (5 CR MORE. EACH:) REFRIG 1-100M BTU (NOT A/C GR EE). REFRIG 10I -500M BTU_ _ _ REFRIG 501-1,000M BTI REFRIG 1,001-1,750M BTU_ REFRIG +1,750M BTU HEAT PUMP & AIR CONDITICNER 0-3 TONS HEAT PUMP & AIR CONDITICNER 3-15 TONS^ HEAT PUMP & AIR CONDITIONER 15-2C TONS HEAT PUMP & AIR CONDITICNER 30-50 TONS HEAT PUMP & AIR CONDITICNER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS_ _ TYPE I HOOD (PER 12' OR i TYPE II HOOD CLOTHES DRYER RANGE = AMOUNT X.,G. CG - -' x 25.00 x 12.00 - x = x x 1.0C = x 12.00 = x 20.00 - x 25.00 = _ x35.00= x 60.00 = x 12.00 = x 20.00 = x 25. CC x 35.00 x €0.00 = x 10.00 = x 10.00 = 4. 5C.CO - x 10.00 = x 1C.00 = x 10.00 = _ x 10.00 x 10.00 Or }JOLT) GAS LOG MISCELLANEOUS (NOT COVERED EL.SEWHERZ) _ UNLISTED GAS APPLIANCE <400,000 BTU_ UNLISTED GAS APPLIANCE >400,000 BTU__ USED APPLIANCE <400,000 BTU USED APPLIANCE >400,00C BTU AIR HANDLER <10,0400 CFM AIR HANDLER >10,000 CFM _ NOTE: SIGNATURE x 50.00 = x10C.00 = x 50.00 x100.00 = x 12.00 = x 15.00 = 0116 FEE I8 $35,00 SUBTOTAL S /v PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 3� w_.._&.. h....gar4manf n4 Q»iteline anti Cafaty '