1985, 12-17 Permit: 00009180 Gas Log^
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S|GNA/URCOF
OWNER OR AGENT
APPLICATION
�JOB ADDRESS:
FEES:
PH
LJC9NSE*:
COUNTER AP�P* _JP�EIA
DATE:
PLA
oc,
FINAL
PLAT NAME:
USE OF PERMIT:
JOB ADDRESS:
MECHANICAL PERMIT
MECHANICAL TOTAL FEE
APPI Dry 00 Range 00 Cas Lo 01 Cas W/H 00 Solid Foel 00 Fee
CAS PIPINC SYGTEM� Qoanti�y �1 Fee
FUEL SOURCE/ Electric N Cas Y Oil N Coal N Wood N Solar N
Processing Fee
l7-1-7--5 7115'd
$18.00
6.00
2.08
10.00
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FEES:
PAID BY:
CA
COUNTER AP�P* _JP�EIA
DATE:
MECHANICAL PERMIT
MECHANICAL TOTAL FEE
APPI Dry 00 Range 00 Cas Lo 01 Cas W/H 00 Solid Foel 00 Fee
CAS PIPINC SYGTEM� Qoanti�y �1 Fee
FUEL SOURCE/ Electric N Cas Y Oil N Coal N Wood N Solar N
Processing Fee
l7-1-7--5 7115'd
$18.00
6.00
2.08
10.00
^78pnu
�° u