BPM19900
Application Date: Permit Fee:
13
Job Address /o 4
Owner a il A e zip pliono
Z41) 2
i
Contractor ail A cs§ Zip Phone
2.
3, Class of C3 COMMERCIAL 0 PIE EN ❑ Addition 0 Alteration 0 Repair — 173 Replacement
Describe Work: /
4.
-METCHANICAL PLUMUT FEES
Heat Pump Tons
Central A/C Tons
Furnace/Heat Pump /Air Conditioner (Per Unit)
Furnace Bru/H
Up to and including 100,000 BTU / 3Tom .. ........................
-9 of Units A/C
Furnace/Heat Pump /Air Conditioner (Per Unit)
Furnace
Over 100,000 BTTJ / 3 Ton .........z ......... ..........................
Completion Date:
Reftigeration Units /Coolers/Lines /Compressor — Commercial
(New or Replacement) (Per Unit)
Boller Chart
.................... $15.00
BTU Fee
........... ............................
Tip to 100,000 ....... .........................
$30.00
100,000-500,000 ..... .........................$30.00
500,000-1,000,000 .......................... , $40.00
1,000,000-1,750,000 ................ . .......$60, 00
Over 1,750,000 ...... ........................$100.00
Boller (use BTUChart to left) ... -- .............
Appliance Vent/Fans ........................$10.00
Notice
Duct System ............ .......... $15.00
I hereby certify that i have read and examined this
application and know the same to be true and correct. All
Gas/Air Outlets 5 x $6.00
provisions of laws and ordinances governing this type If
.............. —First
work will be complied with whether specified herein or
not The granting of a permit does not presume to give
....... ..Additional x $1.00
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
Radiant Heat Systems/Gas/Water
performance of construed on.
Pipin g System ....... ................ $50.00
Modular Home .............. .......... ..... $50.00
Si of Von tractor or Authorized Agent
Permit Issuance Fee . ....... &�KJ
Total
C -Yes C3 No C) NIA
Current License on File
Date
Comment:
WflEN FRUPEKLY VALIDAIL, V (11N 1HIb 13 -1111 lil
Approved By:
Rev. 200810
Application Date
Permit Fee: $ L5
Job Address " ,✓j
Owner Zip Phone _
1. 6 it A < re fi 3
Contractor . Pail A es5 Zip Phone
�4 2.
3. Class of W rk: O COMMERCIAL O RESIDENTIAL O New O Addition O Alteration 173 Repair O Replacement
4 escr Work: ? j, /� F
MECHANICAL PERMIT FEES
Heat Pump Tons
Central A/C Tons
Furnace/Heat Pump /Air Conditioner (Per Unit)
Furnace BTU/H
Up to and including 100,000 BTU / 3Ton ... .........................$15.00
# of Units A/C
Fumace/Heat Pump /Air Conditioner (Per Unit)
Furnace
Over 100,000 BTU / 3 Ton .................... .........................$25.00
Completion Date:
Refrigeration Units /Coolers /Lines /Compressor — Commercial
(New or Replacement) (Per Unit)
Boiler Chart
BTUFee
...................... .I............................. .........................$15.00
Up to 100, 000 ....... .........................$15.00
100,000-500,000 .............................. $30.00
500,000 -1, 000 ,000 ........................... $40.00
1,000,000 -1, 750, 000 ........................$60.00
Over 1, 750, 000 ...... ........................$100.00
Boiler (use BTU Chart to left) ...... , .............
Appliance Vent / Fans ........................$10.00
Notice
Duct System ......... .........................$15.00
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
Gas /Air Outlets 5 x $6.00
provisions of laws and ordinances governing this type of
.................First
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
.........Additional x $1.00
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
Radiant Heat Systems /Gas /Water
performance of construction.
Piping System ....... .........................$50.00
Modular Home ............................... $50.00
Signature of Contractor or Authorized Agent
Permit Issuance Fee . .........................$25.00
l
Total
Current License on File es C3 No O N/A
Date
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YUUK PEFMll
Approved By:
Rev. 2008 -10
°/