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1991, 10-07 Permit App: 91006586 Woodstove
JOB STREET CITY/STAT? OWNER: MECHANICAL PERMIT ; ='PLICATION FORM 99 TInfvrrnat c `=-'orksheet zekci. (�/1 • 99.26e PARCEL NUMBER: PHONE NUMBER: LZ2 ' 1. < MAILING ADDRESS: (Street) (City/State) (Zp) CONTRACTOR: F I Les G 42DEJJ C.EIJI-E►2 LICENSE NUMBER: c -41 G0 &C I i3 PHONE NUMBER: 5091 cra?4n-g9 /, MAILING ADDRESS: E • q3I D 3p2A3u€ S.1000A.tl e. 1,)A 992 D(a (Street) (City/State) (Zp) MECHANICAL WOR DESCRIPTION - ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) � /`V(-..•::::�:}»?-J!;.•.:�-};,<yr:-;x;'f¢:;;;:xxJ�:>o-r;??ao.,_.>•.,-.;-;?cy'M1:s:,'C}c�c:. K �I N W D V I E--'�-. •.Vvw.nGnwww..vV.mw• rnmxwx+.v JK rvFVVYkvV. T iATiriv K v i.JF .ewJvx GAS WATER HEATER ` 1; EQUli'IuIF.:N'#',c10r,Ot1'TU Iil ; ,rv.,.�..,,...-.w�..k-.M ..a..•.,.....,..,.:;... .w..,..,waw,w. a�..., avti.,,3..�,.s. GAS EQUIPMENT+100,000 BTU DUCTWORK)= = rwmwwwwrvvweve,�+n-.rrwV� _-�,^'�• :��::-^^^ GAS>� IP. NQ": I�A L1UT .:::::}:.:. BOILER/REFRIG .1-100M BTU . : ? }ri 6 �+ii�...Te. •wi: ..�w:iGiv. J^}JiC.v+ L< BOILER/REFRIG 501-1,000M BTU p. y[ {/��.,ly �/��/���].M.0 �y�] OTAI }?}�:i V. (��i�[ G • �I.YY. �Y. ' . 'J 1!i : OTAI.- i --4< '+wn -vu,t fK _isv �v-<;C - BOILER/REFRIG +1,750M BTU u d EMBINTAMWOITIYitralet-TiTtift7-7:- 1,10.74*. .:�wwww�.......,.r�....aywoora....,.�..�.w»aar.,. HEAT -FIAT & AIR CONDMO�NER:3-115 TONS 1&.E..ONE) II 5N oJS..?. 3e7SSi EAT PUMP&`AIR CONDITIONER 30-50 TONS�X -" �•., �.r+roa���0}4 j q opo ytc. 000:oroc�c mv>, VENTILATING FANSn WAR) OOLEAMEIV,M1;12:21 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) a .S?r v-r?J,'k-.-----J,-:.:'-y/f•-Vv^,,C•::_-V,}-�.!?-T.-:MJ:Y•' .�.j}`�l.%Y, /.{)}t�:f}-iui.:.!.}'}:•:_Y.i!ri?x Yi-.v--moi �:i: Yiy?:.`"!:?-4}: }::: �?<„,1. wOO.t -_ vri4 }i9$CvYiNr: CLOTHES DRYERS ` AAA AIMITIEL GAS LOGY.----• MISCELLANEDUS (NOT COVERED ELSEWHE UNUSTED GAS APPLIANCE <400,000 BTU UUNSTED GAS APPLIANCE>400,000: BTU :: USED APPLIANCE <400,000 BTU USED APPLIANCE }400 OOO BTU AIR HANDLER <10,000 CFM AIR HANDLER >`I0,000 CFM :::> NOTE MINIMUM PERMIT FEE IS $35.00 SIGNATURE Spokar NUMBER OF UNITS ` ..os...c X EACH UNIT = AMOUNT x10.00 = x25.00 _" x10.00 =,. X 12.00 =.` x 15.00 xt0 0 - x 1200 7., x 20.00 .. ,x 25.00 q. x 35.00„.74.",. x 60.00 x1200=.. X 20.00 1'7 X 25.00.-:='' • x 35.00 - x 60.00-='-:-- x 10.001= X 10.00 x 50.00 X 10.00 X 10.00 = - X 10.00 = X 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = `�. = . _ :r , t,";. • - s ,P.Y ._ , . - _ :, 1 .....�. ---", ..-; •'.,-.5,,,,t4;.,.,,-4-..- ..•. h - ,: , : . �.- `t Y' # ,•;: "iryt.� nR n ..• _ .,.�.�-.� ;- 'r : ;7 -,. r. ; 't ?,a a W 1 ,+yw+.aa r: 7.14"' 4 s f4?.q 1: 4.: s. 12. ai x .., . , . s `'. a•'; ,:. .._ �., •- + •,:+ --.1,-';i:- , ,-;-- ; - .. -- .•.,f 1 - ;,: . SUBTOTAL $ 25.05 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 56.00