1991, 05-21 Permit App: 91002744 Furnace, PipingMtt.M4NIbNL rtnala MrrLWNIIUIt runavi
Infozmation Worksheet..,
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xt A I
PI;OIj$ NUMBEF$r ? Y
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'(StreetX ` ' _ %t j (City/Sf4t1)" ` -(c�'ig)
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PHONE NUMBER: g'72/>,- - " '
517r tg-1,113
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. ` Si'‘(Street)' . 'r- (City/State)
(Zip),".
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• a;;* ` MECHANICAL WORKSHEET/FEE SCHEDULt
r DESCRIPTION,.
NUMBER X EACH
AF UNITS:, UNIT
=AMOUNT
.. DUCTWORK SYSTEM
. WOODSTOVE/INSERT
GAS WATER HEATER
"'+HEATING EQUIPMENT <100,000 BTU
.1 HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG.101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
;HEAT PUMP & AIR CONDITIONER 30-50 TONS
-.,-,,HEAT PUMP & AIR CONDITIONER +50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE IT HOOD
CLOTHES DRYER
RANGE
GAS. LOG
W5 MISCELLANEOUS (NOT' COVERED ELSEWHERE)_ ._
UNLISTED GAS APPLIANCE '400,000 BTU
UNLISTED GAS APPLIANCE- >400,00o -BTU
^
USED, APPLIANCE, 2400,'000 BT[JL •
USED: APPI,IANCFt� 1400, 000 BTU -
AIR H 1ND%ER•' <10, 600' 'CM- _• ,s-
°AIR HANDIER >10 AO¢
agCFM.`,a�-ri
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10-.00 =
x 10.00 =
x 10.00• =
x 10.00 =
x 50.PM
x100.00•=
'x 50.00"`=
”x100.04 =
?; 15. O a;,