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1990, 10-02 Permit App: 90005043 Mechanical FixturesJOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM Informtion Worksheet _n A 750 CITY/STATE/ZIP: PARCEL OWNER:(6- 7e -4d a LAe--" MAILING ADDRESS:. 7 3(3 CONTRACTOR PHONE /3i , 6.,97 NUMBER: ��9i k' z" ,<•.6 - NUMBER: 9-1/-7.3 MAILING ADDRESS: 6;)e) 3-7c-7 (Street) 44,_y -Le / /J14- q/9 (City/State) (Zip) LICENSE NUMBER: J -iA1 -67/e - J3 7cW117 PHONE NUMBER: -// 7e2 J,/,31/45 ( ity/State) (Zip) MECHANICAL WORKSHEET/FEE•SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT HEATING EQUIPMENT GAS PIPING (1 --_4 GAS PIRING (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 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER.15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS <100,000 BTU +100,000 BTU `"OUTLETS) EVAPORATIVE COOLERS _ TYPE I HOOD (PE2' OR 12' PTN. OF, R,1HOOD) 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 <10,000CFM' AIR HANDLER ->10,000 CFM f SUBTOTAL x$10.00 = 25.00 = 10.00 = 12.00 = 1.29 = x x x x x 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 x100.00 = x 12.00 = x 15.00 PLUS: PROCESSING FEE / / ©O /3 ,Q + 25.00 EQUALS:. TOTAL PERMIT FEE .DUE a enmity-fphiartmpnt of Ruildinn and Safety