1993, 03-24 Permit App: 93001782 Mechanical Fixtures i
9::_ l 4---1t:nuunwLL ream Arrusimeas rum ,
'-'2. r . Inforastias Worr•t ,c6yL9tio L-3
JOB STREET S: ci. -1 ( S
CITY/STATE/ZIP:
PARCEL NUMBER: 14 Sat , Of n
OWNER: \....\_0_,..v
� PHOSs NUMBER: Gr z `(
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Q Apt-41e.4s L C< 4r. Ar`r•.-4 LICENSE NUMBER: R 0444-14 j -At I t o t Z.-
PHONE NUMBER: qZt. S>0 v
MAILING ADDRESS: g 1\9 U.. NneN, son.)s t eit4 sl.3 'tai.\ ^t'd^^ 44 2.04
(Street) (Ci y/State) (Zip)
MECHANICAL WORKSHEET/FSE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOOOSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 = L0
HEATING EQUIPMENT <100,000 BTU
x 12.00 = ‘.-Z 'At-
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) -7.._ x 1.0C = 2 v-p
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 HOOD1 x 50. 00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
x 10.00 =
RANGE x 10.00 =
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)._ _ x 10.00 ==
UNLISTED GAS APPLIANCE <400,000 BTU _ _ x x1 50.000.00 =
UNLISTED GAS APPLIANCE >400,000 BTU _ _ 50.00 =
USED APPLIANCE <400,000 BTU x x1 0.00 =
USED APPLIANCE >400,000 BTU =
AIR HANDLER <10,000 CFM Y 12.00x 1 .00 =
AIR HANDLER >10,000 CFM
x- SUBTOTAL $ 2((.,
PLUS: PROCESSING FEE + S 25.00
EQUALS: TOTAL FEE DOB�T
= $ �`Z �-
NOTE: PExxz $25.001
SIGNATURE •
P .
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