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2004, 06-25 Permit App: BLD-04-04715 ACc1T4 OF 0�► Sl3{ e ey MECHANICAL PERMIT APPLICATION PERMIT t ^�t []�� USE: (�/ � c PHONE (Da ontact): ? SPOT PLe_ Uc�O ("44-. X637 (city/state) (zip) LICENSE #: FIGS g"l` gt*C 613 +3ce4 fi a -e doer gA PROJ ADDRECESS: T (i'C J 7 c4A4,0 t� OWNER: MAILING ADDRESS: CONTRACTOR: -MAILING ADDRESS: `(0/07 C c c (street) c -Ad A'[c PHONE #: f CI - sPKc vie L04- /q 2 1 6 (city/state) (zip) (street DESCRIPTION OF WORK 0 or UNITS x COST EQUALS f AMOUNT 1 FUEL BURNING APPLIANCE 2 FUEL BURNING APPLIANCE • OR<100,000 >100,000 X $15 X $19 3 UNLISTED APPLIANCE (ADDITIONAL FEE) =OR<400,000 X $50 4 UNLISTED APPLIANCE (ADDITIONAL. FEE) >400,000 X $100 5 USED APPUANCE(WSEC min. AFUE rating) 1-OR<400,000 X *50 6 USED APPUANCE(WSEC min. AFUE rating) >400,000 x *100 7 BOILER/REFRIGERATION 1-100M BTU X $15 8 BOILER/REFRIGERATION 101-500M BTU X *28 9 BOILER/REFRIGERATION 501-1,000M BTU X $39 10 BOILER/REFRIGERATION 1001-1,750M BTU *57 11 BOILER/REFRIGERATION +1750M BTU $95 12 GAS LOG, GAS INSERT, GAS FIREPLACE x $10 13 RANGE X $10 14 DRYER x $10 15 FUEL BURNING WATER HEATER X *10 16 MISCELLANEOUS FUEL BURNING APPL $10 17 GAS PIPING (ea. Outlet) $1 18 DUCT SYSTEMS X $10 19 VENTILATING FANS $10 20 AIR HANDLER (DOES NOT include dueling) 1-OR<10,000CFM $12 21 22 AIR HANDLER (DOES NOT include ducting) . 'EVAPORATIVE COOLERS >10,000CFM x $19 X $10 23 TYPE I HOOD X $50 24 TYPE 11 HOOD x $10 25 HEAT PUMP/AIR CONDITIONER 0-3 TON x $12 26 AIR CONDITIONER 3-15 TON X *20 27 AIR CONDITIONER 15-30 TON X $25 28 AIR CONDITIONER 30-50 TON X $35 29 AIR CONDITIONER +50TON X $60 30 LPG STORAGE TANK X *10 31 WOOD OR PELLET STOVE/INSERT X $10 32 WOOD STOVE - FREE STANDING X $25, _ - 8 - se _ ❑ CASH ❑ CHECK 0 0 FAXED PERMITS WILL ONLY SE ACCEPTED WITH PATIWENT OF A MAJOR CREDIT CARD DATE: EXPUtES: BANRCARD NUMBER: AUTHORIZED SIGNATURE: SUBTOTAL co PLUS PROCESSING FEE !TOTAL PERMIT FEE DUE $35.00 'Roo