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1988, 09-26 Permit App: 88002911 InsertPARCEL NUMBER: INFORMATION WORKSHEET /854 Ia 4 2S,o0 2%// STREET ADDRESS: 3961 fa, CITY/STATE/ZIP: ,(10 LC)LL 9 ?/..%/a SUBDIVISION: lJ BLOCK: LOT: ZONERWI DISTRICT: [. LOT AREA: g(olon F/A: WIDTH: DEPTH: R/W: 5.Z7 OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: KN,(�Gfl./[ase)ti OWNER: 7.4/,0 Y /J PHONE: 56- - MAILING ADDRESS: 87/94 C ////'p �rw o CITY/STATE/ZIP: �G 10,,' 91c2/ CONTACT: PHONE: lJ' d1 - 902 nWit SETBACKS: - FRONT: LEFT: . RIGHT: REAR: PERMIT USE: T/ 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: i uv L 4/iL\V 111 l viu'Yt'tL y V11 CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: CONTRACTOR LICA: CONTRACTOR: MAILING ADDRESS: MECHANICAL INFORMATION ELECTRIC: GAS: OIL: ENERGY CODE: WSEC: CCAL: WOOD: SOLAR: HEAT PUMP NWEC: UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: *x**x**xxxx*x**xxxx*x***xx*xx*x****x*xx***x******x*********x*xxx**x****xx** MECHANICAL FEES ITEM DESCRIPTION PROCESSING FEE DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER 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 REFRIG +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 AIR HANDLER 1-10000 CFM NUMBER OF YES 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