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2003, 07-17 Permit App: BLD-03-02045 Heat Pump, AC
sli0 (0 /2,.7`2)003 4000 II Valley . id MECHANICAL PERMIT APPLICATION PROJECT I �.... PERMIT �—'—' ADDRESS; •; ( l U 'S ✓tit �!J PER: �Lt lac 1A ec OWNER: • (! �-t� � �`�t �l,L�wt�..._ �Jtx•L I Ct (ijr- PHONE(Daytime nfact): 9 C'C C MAILING AODRES � � - �`� � - � � � { __. 0 ._(1.'-'(L.-10c_[ l,c,/A Gni 03 7 (street) (ai /state) CONTRACTOR LICENSE#: (zip) LI iNe_ z+. � �- 1 c- -�N HEA cI?ci L -7 MAILING ADDRESS: PHONE#: " street cit / zi state - DESCRIPTION OF WORK #OF Oran COST EQUALS AMOI1N r FUEL BURNING APPLIANCEI OR-000,000 $15 FUEL BURNING APPLIANCE >100,000 $19 _ $50 -- UNLISTED APPLIANCE(ADDITIONAL FEE) 1' •4 UNLISTED APPLIANCE ADDITIONAL FEE) }400,000 $100 - — USED APPLIANCE(WSEC min.AFUE ratlng) =OR: 400,000 1131 $50 USED APPLIANCEONSEC min.AFUE rating) >400,000 111 $100 — 110 BOILER/REFRIGERATION 1-100M BTU $1S lu BOILER/REFRIGERATION • 101-500M BTU $28 113 BOILER/REFRIGERATION 501-1,000M BTU 1 $39 BOILER/REFRIGERATION 1001-1,750M BTU - IED BOILE=R/REFRIGERATION +1750M BTUmow 11Eig ^ GAS LOGi GAS INSERT,GAS FIREPLACE $10INI — RANGE $10 DRYER _ $10 FUEL BURNING WATER HEATER $10 1111 "_ ElMISCELLANEOUS FUEL BURNING APPL MEI $10 GAS PIPING ea.Outlet) $1 to DUCT SYSTEMS $10 — 19 VENTILATING FANS El $10 AIR HANDLER DOES NOT Include ductIn. =OR<10,000CFM © $12 -- IN ElAIR HANDLER(DOES NOT Include ductIn0 >10,000CFM $19 — EVAPORATIVE COOLERS $10 ®TYPE I HOOD - -- (�TYPE II HOOD .111 $50 $10 = Ea HEAT PUMP/AIR CONDITIONER 0-3 TON $12 • J a Ea AIR CONDITIONER 3-15 TON $20 .� — ®AIR CONDITIONER 15-30 TON $25 N. 28 AIR CONDITIONER 30-50 TON $35 — 29 AIR CONDITIONER +50TON sumain $60 - "• 30 LPG STORAGE TANK $10 — IIIII 31 WOOD OR PELLET STOVE/INSERT 1111111111MI $10 -- 0 WOOD STOVE-FREE STANDING _ $25 SUBTOTAL ' ❑ GASH CHECK `�:1c-may*! y• -" PAX=PlativECTS WILL ONLY HE ACCEPTED WITH PAY.M3.NT $35.0 OFAMAO CR>:D000Aw PLUS PROCESSING FEE TOTAL PERMIT FEE f ' DATE: EXP : DUE .-- '7 "), o0 BAN1cGARD roc: AVTHORI2HD SIGNATURE: :,+; TOTAL FAC iE.01 , ,i<