1989, 11-13 Permit App: 89004629 InsertI1:FOi `.ATI. )N WORKSHEET
PARCEL NUTTIER :
STREET ItDDRESS: I - : a Q�
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
WATER DISTRICT:
PHONE: jag - gay /i9 7
OF BUILDINGS: ( OF DWELLINGS :
ura:
A
I VAILING ADDRESS: j
CITY /STATE/ ZI P:
CONTACT : PRONE :
:;E•!'1:ACI:S: - I•i?ONT: LEF•'T: RiGIiT: I:F?.P.:
I ra:M1 T
j):4;•}.7.C7101 I.I C}-J:>E I:UMI3ER:
BUILDING I 1:'r'o; FORMATI
( ul:'I'}J.(:7v;:: �. 1'ItONE;
t ;J, 11.I NG Al i1)}' I:: :
7'I:C1'/ENGINEER :
I:'.I LING AL►i)RE`iS:
PHONE: - -
I;EV? :-_ 1 -2iODEL: ADDITION :_"CJI7-JJGG,OF USE:
J er:LI, G(sCUPJ.ITr IcS BUILDING HGT: STOPIFS: '
lli l'.Iai: IO:: S:
FEQJII'}:D I'AI:1:ING:
X
1 IIANDI CAP:
(WI DTII X DEPTH) SQ. FT_ :
SEWER (Y/U) :
I IYDi2AI:T:
v:� i RAC JOR:
:.LILING ADDRFESS:
'ON RACTOR
'..'7RACPOR
MECHANICAL I NFORMATI ON
LIC # : �� 1• L Go. DCS G� / Wee .
ic-Xz &o egept v . fetir -oe..- 6- - =
E .93%b ..5.,,e47015:--, sAM'!474Y�' i9L99 -Ae4'
I
LING ADDRESS:
:LECfRIC: GAS: OIL:
L:ERGY CODE: .'SEC:
CCAL: WOOD: SOLAR: HEAT PUMP
N EC:
UTILITY: SGC:
L'PROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
s ilc7tft i***,,** *s**** ***** t***,:::*******::***::***********:**st*:**-**fc **
II E CHAN I CAL FEES
1)}:SC}:I PYLON
'1:` SING IEE --
)_:71)VE/I1:SERT
WATER }3i-J,'1'1:R
1;r)U 1 P( 100,000 ) i i'U
IiTG EQUIP 4100,000
PI 1'I NG — t OF UN 1 TS
';'UMP 1-100 BTU
'PLUMP 301-500 I3TU
'PUMP 501-1000 BTU
':'UMP 3001-1750 ITU
'111.:1) 41751 BTU
) G 1-100 JYJ1J
IG ) 01-500 1i111
I G 501-100 BTU
.IG 101-3750 ITU
`] G 41750 BTU
CONDI TJ LINER 0-3 LHP
CONDITIONER 3-15 HP
CONDI Ti O:t1:R 1 5-30 HP
CONDITIONER 30-50 HP
C` )':L1 TJG::}'R 450 HP
1I.1,'VI1:G 1'ANS
CO L -: Z
".: I' •:Yl:R
CT,S I,PNLII.`:':E
1 — 1 G');J0
NUMBER OF
YES OR 1.10
PLUMBING FEES
ITEM DESCRIPTION NUMBER OF
rROCESSING FEE
TOILETS
SI NKS
SHOWERS
BATH TUBS
KITCHEN SI NKS
Dl 51iWA_`:131:RS
G7J'BAGE D] SP SRL
CLOTHES WASHER
UTJ LI'L'Y SINKS
ELECTRIC WATER THEATERS
F l,ODR DRAINS
1 1 1)DR SI NIS
S
1:AF, ;11:5S
PODF I)RIJ NS
I2.:,14 SPRINKLER
SEWAGE EJECTOR
WATER SOFT EN R
URINAL
DRINKING FOU1TrA1N
YES OR NO