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I`r <br />/ <br />\ APPLICATION FOR MECHANICAL PERMIT <br />(To be filled in completely by applicant) <br />NAME (0•:7ner) (� �� ✓.�i �lc�' • PHONE NUMBER <br />CONTRACTOR % _ r L��� CG>� �_ PHONE NUMBER <br />ADDRESS LICENSE NUMBERZ_,?,j-42-!§1 <br />TO DO WORK AT THE FOLLOWING_�ADDRESS iVF• <br />USE OF BUTLDING/J��� c< :.,,,ONEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR <br />DESCRIBE WORK_��/�����A� <br />SIGNED BY /tE�"c T � i�� DATE , ,, <br />PERMIT FEES <br />RECHANICAL MIAT_ rAG M nrr. nr nr LI. <br />NO <br />TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS - H.P. Ea. <br />Is <br />REFRIGERATION UNITS •- H.P. Ea <br />BOILERS - H.P. Ea. <br />GAS FIRED A.C. UNITS - TONNTAGE <br />FORCED AIR SYSTEMS - B.T.U. 'mot Ea. <br />GRAVITY SYSTEMS •- B.T.U. M. Ea. <br />_ <br />FLOOR FURNACES - B.T.U. M. <br />WALL HEATERS - B.T.U. M, <br />UNIT HEATERS - B.T.U. M. <br />EVAPORATIVE COOLERS <br />CLOTHES DRYER <br />VENTILATION FAN <br />RANGE HOOD ` <br />AIR HANDLING UNIT C.F.M. <br />WATER BEATER & VENT <br />GAS PIPING <br />TANKS <br />SUB TOTAL $ <br />PERMIT FEE <br />TOTAL FEE <br />APPROVED BY DATE <br />