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1988, 10-06 Permit App: 88003100 Pellet StoveINFORMATION WORKSHEET PARCEL NUMBER: ( 00 STREET ADDRESS: /) 5-0 / 6u CITY/STATE/ZIP: ,jPCOF (}/l / Z1' SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: OWNER: # OF DWELLINGS: WATER DISTRICT: DE -7M luo MAILING ADDRESS: ih k CITY/STATE/ZIP: PHONE: CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: P Sr LJE %r7f ****************************************************************************** CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: BUILDING INFORMATION PHONE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: REQUIRED PARKING: X (WIDTH X DEPTH) SQ. FT.: # HANDICAP: SEWER (Y/N): HYDRANT: PLUMBING INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: *************************************************************************** MECHANICAL INFORMATION CONTRACTOR LIC % : AI/3-77 0 C j / LP-/ A)) CONTRACTOR: '1) 79 / i7t Cij-1 v1 Nc ' MAILING ADDRESS: % 71046 B/ j/9 f�(,() ELECTRIC: GAS: OIL: CCAL: ENERGY CODE: WSEC: NWEC: WOOD: SOLAR: HEAT PUMP UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: *************************************************************************** MECHANICAL FEES ITEM DESCRIPTION PROCESSING FEE DUCTWORK SYSTEM WOODSPOVRAIUSBAWrie GAS WATER HEATER 5- jTA GAS HTG EQUIP(100,000)BTU GAS HTG EQUIP +100,000 GAS PIPING - ## OF UNITS HEATPUMP 1-100 BTU HEATPUMP 101-500 BTU HEATPUMP 501-1000 BTU HEATPUMP 1001-1750 BTU HEATPUMP +1751 BTU REFRIG 1-100 BTU REFRIG 101-500 BTU REFRIG 501-100 BTU REFRIG 101-1750 BTU REF/ZIG +1750 BTU AIR CONDITIONER 0-3 HP AIR CONDITIONER 3-15 HP AIR CONDITIONER 15-30 HP AIR CONDITIONER 30-50 HP AIR CONDITIONER +50 HP VENTILATING FANS EVAPORATIVE COOLERS HOODS CLOTHES DRYER RANGE GAS LOG UNLISTED GAS APPLIANCE %IR HANDLER 1-10000 CFM TR ununr w i nnnn ..r•. NUMBER OF YE OR NO PLUMBING FEES ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS BATH TUBS KITCHEN SINKS DISHWASHERS GARBAGE DISPOSAL CLOTHES WASHER UTILITY SINKS ELECTRIC WATER HEATERS FLOOR DRAINS FLOOR SINKS BAR SINKS ROOF DRAINS LAWN SPRINKLER SEWAGE EJECTOR WATER SOFTENER URINAL DRINKING FOUNTAIN NUMBER OF YES OR NO