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2004, 12-01 Permit App: 04009229 Furnace, AC ('�� z ��`,,��p� v L./� 'F OF :' ��► � � DA MECHANICAL PERMIT APPLICATION PROJECT PERMIT D ADDRESS: 02©n - _ ZZ- USE: `� G-C, ( W,Iti ' C vii't 'OWNER: � CL .vvvo NJ PHONE( ime Contact): Gsl, 023 MAILING AD RESS r a 221A-c( ,cid ur LLII4- rr l °C j street (city/state) •(zip) C NTRACTOR: ( LICENSE#: IS i G Rol aur& A. c 11cu-EPrOo` Sfr — act-1E6 6-i boo g/Z, 'MAILING ADDRESS: PHONE#: 1LctGIa. c,,,fr,,tc, S1cKms.Ing' 4- 1g2t6 (street) (city/state) (zip) DESCRIPTION OF WORK #or minx X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE =ORa100,000 / X $15 x 1s• at) 2 FUEL BURNING APPLIANCE >100,000 X $19 = 3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X $50 a 4 UNLISTED APPUANCE(ADDITIONAL FEE) >400,000 X $100 = r 5 USED APPLIANCE(WSEC min.AFUE rating) =OR<400,000 _ X $50 = 8 USED APPLIANCE(WSEC 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 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 = 111 BOILER/REFRIGERATION +1750M BTU X $95 = 12 GAS LOG,GAS INSERT,GAS FIREPLACE - X $10 = 13 RANGE - X $10] _ 14 DRYER _ - X $10 = 15 FUEL BURNING WATER HEATER _ - X $10 ¶6 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 include ducting) =OR<10,000CFM - X $12 = 21 AIR HANDLER(DOES NOT Include ducting) >10,000CFM - X $19 r _ 22 EVAPORATIVE COOLERS - � X V $10 ' 23 TYPE I HOOD - X $50 - 24 TYPE II HOOD - X $10 a .- 25 HEAT PUMP/AIR CONDITIONER 0-3 TON / X $12 = /2.0o 28 AIR CONDITIONER 3-15 TON ' r X $20 = 27 AIR CONDITIONER 15-30 TON X $25 = 28 MR CONDITIONER 30-50 TON X $35 a 29 AIR CONDITIONER .+50TON X $60 = 30 LPG STORAGE TANK - • X $10 ■ 31 WOOD OR PELLET STOVE/INSERT - X_ , $10 = 32 WOOD STOVE-FREE STANDING - ' X $28 . _ I SUBTOTAL 0 CASH 0 CHECK 0 - ❑ , I PLUS PROCESSING FAXED PERI ffrS WILL ONLY SE ACCEPTED WITH PAY1WENT $'�� OP A 1[JJOR CREDIT CARD . FEE TOTAL PERMIT FEE / DATE: EXPIRES: DUE ,6 .00 BANXCARD NUMBER: - 71 AUTHORIZED SIGNATURE: