1991, 09-18 Permit App: 91006038 Furnaces, Piping of
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CITY/STATE/ZIP: - PARCEL. NUMBER: .
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0g: PHONE NUMBER: q 2-/ CO F
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MAILING ADDRESS:, ,
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CONTRACTOR: ��t6'� S �� �-�l.r�Q���,ICENSE NUMBER:
PHONE NUMBER: q 2-2- SAO 0
MA4LING ADDRESS: r l S (L lty•
(Street) (C�y/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU x 12.00 = 247,.._
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) 2_ x 1.00 = 1...2 .1-
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU x 20.00 =
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 =
REFRIG +1,750M BTU x 60.00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12.00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25.00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLERS x 10.00 =
TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE) x 10.00 = t
UNLISTED GAS APPLIANCE <400,000 BTU _ _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTU x100.00 =
USED APPLIANCE <400,000 BTU - - x 50.00=
USED APPLIANCE >400,000 BTU x100.00 = I.
AIR HANDLER <10,000 CFM x 12.00
AIR HANDLER >10,000 CFM x 15.00. =
SUBTOTAL
PLUS::: PROC ESS INGr,. $
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EQUALS: v r }
NOTE t I PE T PEE I- $35.00 -- FEE, ' '' %41.4k1- �,'m *.7 t.,- 4
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