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1992, 04-22 Permit App: 92002757 Heat Pump IYICbf1411111,ML rcrtw111 ArrubNlwn runna Information WQ,�rksheet //•JO$ STREET ADDRESS: -/LtOCj->• - �-__„ ss CITY/STATF�/ZIP: CES PARCB 1 UMBER: , At C : E;�: ry s P�iONB. NUMBER: SI -._ O -i-Z F. MAILING ADGRESS: . 4 (Street) f (City/State) (Zip) CONTRACTOR: �+.1 S 41 v M,`_&.... LICENSE ?NAB : _Pc�2 ) \,l 0 (1 Z 70 • PHONE NUMBER: ck).__'t-- -C) J MAiLING ADDRESS: cil 1 R-L 3 ' %,:k.c.___. C..Aa- L'cst?..D (Street) (City/State) (Zip) . MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OFFUUNNITS EAC = 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 = HEATING EQUIPMENT +100,000 BTU x 15.00 = GAS PIPING (1 - 4 OUTLETS) x 4 . 00 = GAS PIING (5 OR MORE. EACH: ) x 1. 00 = 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 _ _ l x 12 . 00 = 1"'-" .. 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 = 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 = 1 USED APPLIANCE >400, 000 BTU x100. 00 = AIR HANDLER <10,000 CFM x 12 . 00 = AIR HANDLER >10,000 CFM x 15. 00 = � .. SUBTOTAL - $ l 2> f' 4 1 ;PLUS: PROCESSING FEE + $ 25.00 VI , -i---.0.4--- .:.4.0.100444-014.4 M �t 0,-17,,)e - ; EQUALS: TOTAL PERMIT ' F' ' NOTiZ . . " r. ' . MIT fl 35.00 FEE DUE ae $ 3-i �. ti'- ' TIMI Rin;Au47 4727 s ennb.no Mus OQ?RA mini dK{L1A7R