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1991, 11-05 Permit App: 91007572 Wood StoveMECHANICAL PFR V"I :: PLICATION FORM I / - -75% oZ - MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) FmmK9v.Ji:,�RnWCvvwuii.v+wNnwvrnmm A}S%::mmKSF dWiiM.v}# M {rw`}S�xA']•r:tt,b J9ue.JW GAS WATER HEATER >�QP.:.�i!>`� .vnwrLwnwvrwiuwuw:vrM}. wuw:..iA'.Vire}Xi{3iA�ir}�i-ieiS'F.wuL+i GAS EQUIPMENT+100,000 BTU DUCTWORK)='Y-x : Aia-:aa00 MO. BOILER/REFRIG .1-100M BTU.„ C3 3. ------ l 7LrA:eeY "S+v-vas:�isn� BOILERIREFRIG 501-1,000M BTU BOILER/REFRIG +1,750M �� 1RACOND. HEAT PUMP &AIR CONDI HEAT PUMP "AIR CONDMONER 30-50 TONS`~"b— gjamp t VENTILATING FANS' - . 4'r_ '-'" =," =� : ~ ��1! . � �'`?'..; .. -Lr�b�7 x S{ �� ys.c.r• � S,M, v ,crrii.�'�&�i�� TYPE I HOOD (PER 12' OR 12' PTN. OF OOD .. .;xc�;.Jnr..rycolQ+hS;:!cwv,.r:;:•_••}•?�• x...';az%r';^?'^x:;rxsr;..y�ar+ 4.. . ��'.Yy '1{i�iYr:}..ii•::ti:'ti �'�S :..vv:. �.?..v: a: . 'i}y;':j{^i=}: r:4QL:i�.ri:::i r.:�':i�:ii "` - vwwvGih.3!n...... rr.0.n:. A.ASCYiM, nOG:m3.,WLv0.` r.._K.:x9vAiFLuw„W":vavir.JiwM• .:if}:?.o„{?;.;.'•'•3^�'p'Rc!!gc'ya,-'%�t�m:: r.*` :MlSCEi�ANFOUS OT�01/EREDELSEiNFIEfIE . �r:.�.. UNLISTED GAS APPLIANCE <400,000 BTU :ULINSTED GAS APpUANCE�00,OOt� BTU <<>�'::<>><-`: USED APPLIANCE <400,000 BTU BUSED �1PPUANC�.>40�t?OQk;BTU AIR HANDLER <10,000 CFM AIRiAN NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATUR NUMBER OF UNITS Informat;o- z`forksheet 5 %c( JOB STREET A:=_=:=SS:__J - CITY/STATE/ZIP: f22�L LCLL "0 4-� 3� O PARCEL NUMBER: OWNER: Y) I PHONE NUMBER: q 2-I - q'1�Y,:Df5 MAILING ADDRESS:_— r. _ (Street) (C:ry/State) (zip) CONTRACTOR: C-4 I inn L740L )tel C �1ifye LICENSE NUMBER: r4lG0 &C,) i3 t�'L4 PHONE NUMBER:�SDq) GTo1(c-8�I 1 I MAILING ADDRESS: E • q 3) b �•p 2AGqu e _N ,rnK.A,t1 e_ 2 D& (Street) (City/State) (zip) - MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) FmmK9v.Ji:,�RnWCvvwuii.v+wNnwvrnmm A}S%::mmKSF dWiiM.v}# M {rw`}S�xA']•r:tt,b J9ue.JW GAS WATER HEATER >�QP.:.�i!>`� .vnwrLwnwvrwiuwuw:vrM}. wuw:..iA'.Vire}Xi{3iA�ir}�i-ieiS'F.wuL+i GAS EQUIPMENT+100,000 BTU DUCTWORK)='Y-x : Aia-:aa00 MO. BOILER/REFRIG .1-100M BTU.„ C3 3. ------ l 7LrA:eeY "S+v-vas:�isn� BOILERIREFRIG 501-1,000M BTU BOILER/REFRIG +1,750M �� 1RACOND. HEAT PUMP &AIR CONDI HEAT PUMP "AIR CONDMONER 30-50 TONS`~"b— gjamp t VENTILATING FANS' - . 4'r_ '-'" =," =� : ~ ��1! . � �'`?'..; .. -Lr�b�7 x S{ �� ys.c.r• � S,M, v ,crrii.�'�&�i�� TYPE I HOOD (PER 12' OR 12' PTN. OF OOD .. .;xc�;.Jnr..rycolQ+hS;:!cwv,.r:;:•_••}•?�• x...';az%r';^?'^x:;rxsr;..y�ar+ 4.. . ��'.Yy '1{i�iYr:}..ii•::ti:'ti �'�S :..vv:. �.?..v: a: . 'i}y;':j{^i=}: r:4QL:i�.ri:::i r.:�':i�:ii "` - vwwvGih.3!n...... rr.0.n:. A.ASCYiM, nOG:m3.,WLv0.` r.._K.:x9vAiFLuw„W":vavir.JiwM• .:if}:?.o„{?;.;.'•'•3^�'p'Rc!!gc'ya,-'%�t�m:: r.*` :MlSCEi�ANFOUS OT�01/EREDELSEiNFIEfIE . �r:.�.. UNLISTED GAS APPLIANCE <400,000 BTU :ULINSTED GAS APpUANCE�00,OOt� BTU <<>�'::<>><-`: USED APPLIANCE <400,000 BTU BUSED �1PPUANC�.>40�t?OQk;BTU AIR HANDLER <10,000 CFM AIRiAN NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATUR NUMBER OF UNITS X EACH UNIT =AMOUNT x 10.00 x 25.00 x 10.00 =._. x 12.00 = .v x 12.00` .x25.00r x 35.00, x 12.00" •• )i 20.00, t;717 X 25.00 x 60.00':. x 10.00 x 10.00 x 50.00 x1 O OO : X10.00 x 10.00 x 10.00 = x 10.00 = x 50.00 = X100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = Y :'L r. :;`tea.,. rn s M a _... :.. - - SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 50'oc) Spokar e "- !- -'-