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GENERAL INFORMATICN
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* MAIL ING ADDRESS :
* CITY/STATE/ZIP:
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* SCTeACKS
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* PERMIT LS=:
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# CONTR LIC#:
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# CONTRACTCR---------------------------------------- PFCNE -------
MAILING
-----MAILING ACCFESS'--------------- ---- -------------------- #
* MECFANICAL INFORMATION
* CONTR LIC#:
* CONTRACTOR:___ ____ PFCNE:____-___-
* MAILING ADCRESS:_ #
* ELECTRIC:_— GAS:—_ CIL:___ CCAL:_— WOOD:___ SOLAR:___ FEAT FUMP:_—
* *
MECHANICAL FEES PLUMBING FEES
IIE-A DESCRIPTION
PROCESSING FEE
DUCTWORK SYSTEM
wOCCSTCVE/INSERT
GAS WATER HEATER
GAS HTG EQUIP<10C,000>BTU
GAS hTG EQUIP+100,000 BTU
GAS PIPING - # OF UNITS
hEATPUNP 1-100M ETU
HEATPUMP 101-500N BTU
HEATPUMP 501-19000M BTU
HEATPUMP 19001-1750M BTU
HEATPUMP +19750M BTU
REFRIG 1-100M BTU
REFRIG 101-500M BTU
REFRIG 501-19000M BTU
REFRIG 1,001-19750M BTU
REFRIG +1,750M BTU
AIR CONDITIONER 0-3 HP
AIR CCNCITICNER 3-15 hP
AIR CCNDITICNER 15-3C HP
AIR CCNGITICNER 30-50 HP
AIR CONDITI-CNER +50 HP
VENT ILAT ING FANS
EVAPORATIVE COOLERS
HOODS
CLOTFES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM
AIR HANDLER 10000+ CFM
NLMBER CF
YES OR NO
ITEM DESCRIPTION
PROCESSING FEE
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
GAF'BAGE DISPCSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOCR SINKS
BAR SINKS
ROOF GRAINS
LAWN SPRINKLER
SEWAGE EJECTCR
WATER SOFTENER
URNAL
DRINKING FOUNTIAN
NUMBER OF
YES OR NO