2003, 03-30 Permit App: BD03-018 Mechanical Fixtures I1t;F i. , 1 : - FF. TO '_+2:'711E F'.02 0-3
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MECHANICAL PERMIT APPLICATION _
PROJECT // �D PERMIT
ADDRESS: �4 cos- E, l�0c-k e li USE:
OWNER: Go �� o klrlo/� PHONE(Daytime Contact): ci y_3 Cf, y
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MAILING ADDRESS. /4945— 6-- `S D G k k)E LI— -s 'o 1‹,69f✓ AL LE (1 - • q9z 16
_(street) (city/state) (zip)
CONTRACTOR: LICENSE it:
f AE:RS 6/01 s SHEET M&TftL •' A N DE1.SI I /ES 11/Z
MAILING ADDRESS: PHONE#:
E. 1390 3 TRF IIT _ 7 P.g —096a
SPD k,-,J L' O LL E' q/ L1)f) q 9.2 l-6
(street) (city/state) _ (_zip)
- DESCRIPTION OF WORK #or MU X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =0114100,000 L _ X $15_ Iffigir. cv
2 FUEL BURNING APPLIANCE >100,000 X_ $19 =
3 UNLISTED APPLIANCE(ADDITIONAL FEE) =0R4400,000 X $50-
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 = _
5 USED APPLIANCE(WSEC min.AFUE rating) =0R<400,000 X $50
6 USED APPLIANCE(INSEC min.AFUE rating) 7400,000 X $100 =
—7 90ILER/REFRIGERATION 1-100M BTU X $15
8 BOILER/REFRIGERATION 101-500M BTU X $28 =
9 BOILER/REFRIGERATION _ _ 5014 000M BTU X $39
10 BOILER/REFRIGERATION 1001-1,750M BTU ' X $57 =
11 BOILER/REFRIGERATION +1750M BTU - X $95
12 GAS LOGS GAS INSERT,GAS FIREPLACE - ..'-1 X $10 m /D•00 ,
13 RANGE — X $10 =
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14 DRYER - X $10 =
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�5 FUEL BURNING WATER HEATER - X $10
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16 rMISCELLANEOUS FUEL BURNING APPL -
17 GAS PIPING(ea,Outlet) - a X $1 = 2. p-‘),
188 DUCT SYSTEMS - X $10 •_
19 VENTILATING FANS - X $10
20 AIR HANDLER(DOES NOT include ducting) =0R<10,000CFM _. 1 X $12- _ __..
21 AIR HANDLER(DOES NOT Include ducting) _710,000CFM X $19 i
22 EVAPORATIVE COOLERS .. X $10
23 TYPE I HOOD -- - 1 X 350 = ‘ O3 C
24 TYPE 11 HOOD
25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 a �C). ,C
26 AIR CONDITIONER 3-15 TON ________X__,___ $20 = ��>(,)
27�AiR CONDITIONER 15-3D TON X $25
28 AIR CONDITIONER _ 30-50 TON X S35 • 1 CA J (-D
29 AIR CONDITIONER +50TON X $80 =
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30 LPG STORAGE TANK = l\X $10 _ J
31 WOOD OR PELLET STOVEJ1NSERT - X $10 = 1- C)3_. \
32 WOOD STOVE FREE STANDING X - $25 - - +
_.
_ __ SUBTOTAL '
V/st ". ` ?' 3'7, CFO Ap
E CPSx RCK ❑ ❑ ` ':.f::: PLUS PROCESSING— $35.00
/ =nXrEP1-)PII.I TS"TILL ONLY BE ACCEPTED"STPli PAY/.iENT ��L
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6F A 1.W OR CSP.D1T cARD
TOTAL PERMIT FEE
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