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1989, 02-01 Permit App: 89000228 Pellet StoveINFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: )7/3` X i7 ,7,!„.7. CITY/STATE/ZIP: �/���� �_. 99aa SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTE: R/W: r OF BUILDINGS: C OF DWELLINGS: WATER DISTRICT: OWNER: MAILING ADDRESS: >Z);• 'y' //5,2,? CITY/STATE/ZIP: CONTACT: PHONE: - y7ao- /9a 3 SETBACKS: - FRONT: PERMIT USE: LEFT: PHONE: RIGHT: REAR: BUILDING IN'FORMAT'ION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAI LING ADDRESS:' PHONE: ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: NEW: R}ODEL: ADDITION: DWELL UNITS: OCCUPANT LOAD: BUILDING DIMENSIONS: REQUIRED PARKING: x # HANDICAP: STORIES:• (WIDTH X DEPTH) SQ. FT.: SEWER (Y/N): HYDRANT: CONTRACTOR LICE: CONTRACTOR: [Nu 1:'rkJIJJ 1'1 ON N MAILING ADDRESS: x***lt****************************************ltititf *'***** cit***itltltitlft*******: MECHANICAL INFORMATION CONTRACTOR LIC#: CONTRACTOR: �` Leocc/734 ( (7o (i91J EN C L,1f 1C2, 17VC . MAILING ADDRESS: . �, / ,9fa9(i{ ' , Cpb9/V E (4C/7( ELECTRIC: GAS: OIL: CCAL: WOOD: f SOLAR: HEAT PUMP ENERGY CODE: WSEC: NWEC: APPROACH PRESCRIPTIVE: UTILITY: SGC: POINT: COMPONENT: SYSTEMS: s************************************************************************** MECHIANICAL FEES DESCRIPTION i?OCESSING FEE )UCT ORK SYSTEM r.),3DSTOVE/INSERT :AS WATER HEATER ;AS HTG EQUIP(100,000)BTU AS HTG EQUIP +100,000 3AS PIPING — $ OF UNITS iEATPUMP 1-100 BTU 'F.ATPUMP 101-500 BTU ATPUMP 501-1000 BTU E1,TPUMP 1001-1750 BTU. irk; I'PUMP +1751 I3TU U -:FRIG 1-100 BTU :FRIG 101-500 BTU >_rrRZG 501-100 BTU :FRIG 101-1750 BTU ?E RIG +1750 BTU R CONDITIONER 0-3 HP - • CONDITIONER 3-15 HP ▪ CONDITIONER 15-30 HP CONDI TI ON ER 30-50 HP CONDITIONER +50 HP k'ILATING FANS .PORATIVE COOLERS SDS IMES DRYER E ; LOG .LISTED GAS APPLIANCE R 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 I3AR SINKS ROOF DRAINS LAWN SPRINKLER SEWAGE EJECTOR WAVER SOFTENER URINAL DRINKING FOUNTAIN NUMBER OF YES OR NO