1990, 09-17 Permit App: 90004642 Plumbing Reversal, FixturesINFORMATIbN WORKSHEET
PARCEL NUMBER :
ADDRESS:£' ,73/2P‘.,//.4, ,J
STREET D
CITY/STATE/ZIP: 5 a'n'1.<y % S 4
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
OWNER:
# OF DWELLINGS: WATER DISTRICT:
PHONE: -j`-e2 - 5-1_2 7?
MAILING ADDRESS: 7 o 4' ) / E Y
n p
CITY/STATE/ZIP: ljPPo /167. G4--- As 4
CONTACT: PHONE: -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
BUILDING INFORMATION
PHONE:
PHONE:
DWELL UNITS: OCCUPANT LOAD:
,0
BUILDING DIMENSIONS:
REQUIRED PARKING:
BUILDING HGT: STORIES:
X (WIDTH X DEPTH) SQ. FT.:
HANDICAP: SEWER (Y/N): HYDRANT:
p5Le pC 4-9/
Revised 1/88
PLUMBING INFORMATION
CONTRACTOR LIC#: `I C -a cis s
pn
CONCTOR: 4 C / Act-( 2
TRA
MAILING ADDRESS: 1,Q fox /(3( 37
,� 7m
-m6
**************** ********************************************************
MECHANICAL INFORMATION
9'9 2/3 —i'537
CONTRACTOR LICi:
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC: GAS: OIL: CCAL: WOOD: SOLAR: HEAT PUMP
ENERGY CODE: WSEC: NWEC: UTILITY: SGC:
APPROACH: PRESCRIPTIVE:_ - POINT: COMPONENT: SYSTEMS:
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 - 4 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
AIR HANDLER 10000 CFM
NUMBER OF --
YES OR NO
PLUMBING FENS
ITEMDESCRIPTION
-PROCESSING FEE
TOILETS
SINKS
SHOWERS
BATH -TUBS,
KITCHEN SINKS
NUMBER OF
CYFS R NO
/r �p 00
00
/� h oo
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 /
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