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1990, 06-20 Permit App: 90002861 Pellet Stove
INFORMATION WORKSHEET PARCEL NUMBER: -. `STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT AREA: F/A: ZONE: WIDTH: DISTRICT: DEPTH: R/W: a I OF BUILDINGS: OF DWELLINGS: WATER DISTRICT: OWNER: MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: cAesidM '`'` Pilot; E: PHONE: SETBACKS: - FRONT: LEFT:' RIGHT: REAR: 11.1M1'r USE:__ SY\ aQ sssssssrsssssssrssssssrrxrrx*x*sr**r**rrsssrr*s*************-**t.atrvrtr** **ltd -s=' BUILDING'INFORMATION • CONTRACTOR -I.FCEN• SE NUMBER : an CONTRACTOR: _ _ I'HONE:- _ - - r - I.I NG ADDR FSS : ARCH I TE CT/ EUG I NEER: : PHONE : F• '.1tII.ING ADDRESS: me- NEW:: - RFI1ODEL ADDITION: = CHANGE OF USE:-' - IIWY.I.L UtiITS: OCCUPANT LOAD: BUILDING IGT: STORIES: - 'WILDING DIMINSIONS:_ • REQUI RED I'ARKI NG: Xg4talael x= JUANDICAP': (WIDTH X -DEPTH ) SQ. F1'. - SEWER (Y/N) HYDRANT: C ):',YAC_ .ojR LIC#: CONTRACTOR: MAILING ADDRESS: CONTRACTOR LICE: CONTRACTOR: 4 MECHANICAL INFORMATION FAzeo sA,PPEN . deNTE4-r-4'C = . MAILING ADDRESS: E Fvo 3.0.ef uelem:lo#6" AZ9 ELECTRIC: GAS: OIL: CCAL: ENERGY CODE: WSEC: NWEC: WOOD: SOLAR: HEAT PUMP UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: *!xt*******************************************1******t***********1*11*1* MEC}1ANICAL FEES TM DESCRIPTION NUMBER OF tO ESS1NG FEE YES OR NO IC'LWC)RK SYSTEM iDI)SLOVE/ I T:S}-:RT WATER HEATER HTG EQUIP(100,000)151'U_ S- 1ITG - EQUI'P +100,000 ___ S ISI PI NG f OF AIN 1 TS :ATI'uMP=:1-100 • BTU :ATPUMP` :101-= 5001 BTU - :? PUMP 501-1000 131Ei ;TTPUMP"10011750 1T'U :fTPUMP +1751 BTU' :- 1G 1-100 BTU FPIG' 101 500 BTU A -TIG 501-100 BTU- :F'kIG 101-1750 BTU .FRIG +1750 BTU R7 CONDI TIONER' 0-3 HP: _R CONDITI ONP.R- 3-15 ' 11P R CONDIT1ONF.R 15-30 IHP R CONDITIONER 30-50 HP R CONDITIONER +50 IIP !:TIIJ,TIt:G FINS APOR A'1' 1 V F. COOLERS 0:)S 2THES DRYER !r.E• S IIiG LI !:'i'E0 GAS AI'PI,1 ANCE r= U; Iit t:I>I.I:R 1-10000 CI -14 PLUMBING FEES ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS BATH TUBS KITCHEN SIi:}:S DISHWASHERS GARBAGE= DI SPOSAL CLOTHES WASHER UTILITY SINKS E_LECI'RTC WATER HEATERS FLOOR DRAINS FLOOR S I N KS BAR SINKS' S ROOF DRAINS= LAWN SPRINKLER SEWAGE EJECTOR WATER SOFTENER URINAL' `: I)RI I: R.I N G FOUNTAIN NUMBER OF YES OR NO