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1988, 12-15 Permit App: 88004013 Pellet StoveINFORMATION WORKSHEET PARCEL NUMBER: n�� 5� f-- 2"/ d STREET ADDRESS: CITY/STATE/ZIP:�4�ie/ SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A- WIDTH: DEPTH: R/W: — OF BUILDINGS: OF DWELLINGS: WATER DISTRICT: OWNER': PH NE: MAILING ADDRESS- CITY/STATE/ZIP: A YZ CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: xxsxxxxxsrxxxxx*xxxxxxx*xxs: ft ft yr x-yr*ytxxxxyrx*xyt ytxxftxxxxxxxxzxxirxx*xxxzxx*xxirxir erx*sfr BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: \ ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: NEW: RE -MOD ADDITION: MAR OF USE: DWELL UNITS: ANT LOAD: BUILDING HGT: TORIES:' BUILDING MENSIONS: X (WIDTH B DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: CONTRACTOR LIC#: \� CONTRACTOR: MAILING ADDRESS: PLUMBING 1Nr-UKMATION !' MECHANICAL INFORMATION CONTRACTOR LIC# : �D G 173 IS a CONTRACTOR: c 4�--/ V 0, Z: V i ZW , =/V MAILING ADDRESS: C , ��� C%�� (,( �/� (� S�)C14fE v 7 i ELECTRIC: GAS: OIL: CCAL: ENERGY CODE: WSEC: NWEC: WOOD:_ SOLAR: HEAT PUMP UTILITY: SGC: APPROACH;- PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: xxxxx*xxxxxxx*xxxx*x*xxxxx*x*x'xxxxxxx*xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx MECHANICAL FEES ITEM DESCRIPTION NUMBER OF OCESSING FEE YES OR NO DUCTWORK SYSTEM "OODSTOVE/INSERT J,2--� ^S WATER HEATER _-AS HTG EQUIP(100,000)BTU '-SAS HTG EQUIP +100,000 AS PIPING --# OF UNITS EATPUMP 1-100 BTU !�-ATPUMP 101-500 BTU iEATPUMP 501-1000 BTU ,EATPUMP 1001-1750 BTU 'F.ATPUMP +1751 BTU EFRIG 1-100 BTU EFRIG 101-500 BTU :FRIG 501-100 BTU -'FRIG 101-1750 BTU :FRIG +1750 BTU %R CONDITIONER 0-3 HP CR CONDITIONER 3-15 HP F=R CONDITIONER 15-30 HP fR CONDITIONER 30-50 HP iR CONDITIONER +50 HP 21TILATING FANS 'APORATIVE COOLERS ,ODS '7THES DRYER 4GE .S LOG iLISTED GAS APPLIANCE rR HANDLER 1-10000 CFM PLUMBING FEES ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO 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