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2003, 10-07 Permit App: BLD-03-02707 Mechanical Fixtures
10/07/2003 16.,20 5094841505 RR HEATING mut City of Qnr% !2naa VAIPV Mechanical'Permlt Application Fax # 688-0037 I Fuel burning ap lig 2 Fuel burning apple 3 Unlisted appliance 4 Unlisted appliance 5 Used appliance 6 Used appliance. 7 Boiler/refri eratlon 8 Boiler/refrigeration 9 Boiler/refrigeration 10 Boiler/refrigeration 11 Boiler/refri eration 12 Gas loq, gas inner of Work additional charge) additional char e WSEC's min. AFUE ratin WSEC's min. AFUE ratin lace 14 Dryer 15 Fuel burning water heater 16 Miscellaneous fuel burning appliance 17 Gas piping, (each outlet) 18 Ducts stems 19 Ventilating fans 20 Air handler (does not include ducting) 21 Air handler does not include ducting) 22 Evaporative coolers 23 Type I hood 24 Type II hood 25 Heat pump/air conditioner 26 Air conditioner 27 Air conditioner 26 Air conditioner 29 Air conditioner 30 LPG storage tank 31 Wood or eellet stove/Insert 32 Wood stove - free standing 0 Cash 0 Check 11 Visa 0 MasterCard - or < 100,000 > 100,000 - or < 400,000 > 400,000 - or < 100,000 > 400,000 1-100M BTU 101-500M BTU 501-1,000M BTU 1,001-1,750M BTU + 1,750M BTU - or < 10,000 CFM > 10,000 CFM 0-3 tons 3-15 tons 15-30 tons 30-50 tons + 50 tons Foxed permits will only be accepted with payment of a major credit card Date, Expires: Bankcard Plumber. Authorized Signature: �Mllllll ElmHIMME-F ••- • =�' • •• •M •• 28.00 Plus Processing Fee 35.00 Total Permit Fee Due 03.00 OCT 04 2003 16:29 5094841505 PAGE.02