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Permit: BD03-280 Heat Pump, AC
al? OF Spane ,,,'' p 3 - 2S(0 ?(:)(\a,M MECHANICAL PERMIT APPLICATION tio- ,/Sfy.�PROJECT PERMIT C "�, / ADDRESS: 2� S . USE: 6eC.� 7 U?kl 2CC /VC SC-s/e4$1 ` PHONE (Daytime Contact): ?i y 2 4/J23 F. 3Vkc �9--o% fstreet) (city/state) (zip) CONTRACTOR: LICENSE 0: Fife, cicti-EPriilt*Ce;m3 GcHErm-; 600 MAILING ADDRESS: PHONE 0: SCC -'12 -?-71% OWNER: r 1 L.Thcrc WC LO MAILING ADDRESS: C SP o (cIn e w off- 'tq 21 (street) (city/state) zi DESCRIPTION OF WORK * or x mu X COST EQUALS 1 AMOUNT 1 FUEL BURNING APPLIANCE = OR.4100,000 / X $15 = Ar 00 2 3 FUEL BURNING APPLIANCE >100,000 X $19 ra UNLISTED APPLIANCE (ADDITIONAL FEE) =0R<400,000 X 550 = 4 UNLISTED APPUANCE (ADDITIONAL FEE) >400,000 X 5100 5 USED APPUANCE(WSEC min. AFUE rating) =OR.4400,000 X 550 - 6 USED APPLIANCE(WSEC min. AFUE rating) >400,000 X 5100 = 7 8 BOILER/REFRIGERATION 1-100M BTU X 515 = BOILER/REFRIGERATION 101-500M BTU X $28 - 9 BOILER/REFRIGERATION 501-1,000M BTU X 539 - 10 BOILER/REFRIGERATION 1001-1,750M BTU X 557 11 BOILER/REFRIGERATION +1750M BTU - X 595 = 12 GAS LOG GAS INSERT, GAS FIREPLACE - , X 510 = 13 RANGE - X $10 K 14 DRYER - X 510 - 15 FUEL BURNING WATER HEATER - X 510 = 16 MISCELLANEOUS FUEL BURNING APPL - X $10 = 17 GAS PIPING (ea. Outlet) - X $1 = 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - X 510 = 20 AIR HANDLER (DOES NOT include ducting) -OR<10,000CFM X $12 = 21 AIR HANDLER (DOES NOT Include ducting) >10,000CFM x 519 = 22 EVAPORATIVE COOLERS - X $10 = 23 TYPE 1 HOOD - X ' 550 = 24 TYPE II HOOD - X 310 25 HEAT PUMP/AIR CONDITIONER. 0-3 TON ,/ X 512 2 _ o 26 AIR CONDITIONER 3-15 TON_ X 520 = 27 AIR CONDITIONER 15-30 TON X 525' _ 28 IF 29 A!R CONDONER 30-50 TON X $35 = AIR CONDITIONER +50TON X 560 = 30 LPG STORAGE TANK - X 510 r _ 31 WOOD OR PELLET STOVEIINSERT - X 510 = 32 W000 STOVE - FREE STANDING- X 525. _ ❑ HATH. — -r SUBTOTAL -►- ' CASH • CHECK 0 IIIIIIIIIIIII 0 PLUS PROCESSING FEE $35.00 FAXED rERKTS aau, max as Accsrrea Norm PAYM r OFA MAJOR CREDIT CARD 1+�rnraFc, NOTAL PERMIT FEE )DUE 2�©0 62 BANKCARD NUMBER: AUTHOR"ZED SIGNATURE: