HomeMy WebLinkAbout2005, 05-19 Permit App: BLD-04-04395 Mechanical Fixtures Sitiolian, e -
MECHANICAL PERMIT APPLICATION I
PROJECT - PERMIT
ADDRESS: . Cf ZZ.( of•Vel t,1eK USE: 4 J 76PrtCCf. (G�.rzte(h!
OWNER:
Dag ,r IS Atc< Silt cl�1�_ �'PHONE Da me �
Contact):q 2?_j(� /
MAILING ADDDRESS: 41 2:2 (' k - Ve(zrQ il_ ( /
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(street) (City/state) •(zip)
CONTRACTOR: 4 LICENSE#:
ZC -o G.vc U C:. cu.E 6640 (, Vfli— Gc HE,6 6--Pt OQUif&
MAILING ADDRESS: PHONE#:
• 00 CC7i2-7—Yr6 (
f Ci LG2 Cc, A( o SP0Ka.rn•e' u4 ' 8216
(street) (City/state) (zip) ,
DESCRIPTION OF WORK #or UNirs X COST _ MI�UAU AMOUNT
1 FUEL BURNING APPLIANCE =OR<100,000 ( X $15• .1f-C
2FUEL BURNING APPLIANCE >100,000 X $19 =
3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X $50 =
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100
5 USED APPLIANCE(WSEC C min.AFUE rating) -OR<400,000 X $50 22
6 USED APPLIANCE(WSECC 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 m
10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 , -
11 BOILER/REFRIGERATION +1750M BTU X $95 - .
12 GAS LOG;GAS INSERT,GAS FIREPLACE T - w X, $10 _
13 RANGE L--- - X $10 =
14 DRYER - X $10 is 1
T1 FUEL BURNING WATER HEATER - X $10 c 1 . I
16 MISCELLANEOUS FUEL BURNING APPL - X $10 • _
17 GAS PIPING(ea.Outlet) - X $1 =
18 DUCT SYSTEMS �� - ' X $10 =
19 VENTILATING FANS - X $10 -
20 AIR HANDLER(DOES NOT =0R<10,000CFM ' X $12
EVAPORATIVE21 AIR hiANDLER(DOES NOT Include ducting) >10,000CFM X $19 =
22 •• - - X $10 - .
23 TYPE I HOOD - ' X --135"---77
24 TYPE II HOOD - X $101- a
25 HEAT PUMP/AIR • 0-3 TON X $12 -
26 AIR CONDITIONER 3-15 TON X ; $20 1 _
27 AIR CONDITIONER 15-30 TON X $25 a
28 AIR CONDITIONER 30-50 TON X $35 m
29 AIR CONDITIONER 4,��+50TON T X $60 a
30 LPG STORAGE TANK - . X $10 m
31 WOOD OR PELLET STOVE/INSERT - X $10 =
32 WOOD STOVE-FREE STANDING - X $25 -
-
. - --r-- SUBTOTAL
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0 CASH ❑ CHECK 0 = 0 - PLUS PROCESSING
FAXED PERAIITS' LL ONLY BE ACCEPTED o7PPH PAY1WENT $35.00
OF A MAJOR.CREDIT CARD FEE
TOTAL PERMIT FEE # 0(2
DATE: EXPIRES:
DUE ii' 't '
BANRCARD NUMBER:
AUTHORIZED SIGNATURE: