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1989, 01-19 Permit App: 89000117 Pellet Stove
INFORMATION WORKSHEET PARCEL NUMBER: CITY STATE ZIP. �YQJ 9a� STREET ADDRESS: 7.O �� i �/�� - . CITY STATE ZIP: • 9� SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: OF BUILDDINGS: OWNER: f OF DWELLINGS: WATER DISTRICT: qZ-teites—irJ MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: t S/ y- 9,?/'- a 77 SETBACKS: - FRONT: PERMIT USE LEFT: PHONE: RIGHT: REAR: t * f * * * * * * * * * * * *it* t * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * It*** * * * * * * * * * * * * * * * * * * * * * * s CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: BUILDING INFORMATION PHONE: ARCHITECT/ENGINEER: MAILING ADDRESS: NEW: ADDITION: • *s..:. PHONE: E OF USE: DWELL UNI OCCUPANT LOAD: BUILDING HGT: STORIES:. _ BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: f HANDICAP: SEWER (Y/N): HYDRANT:'- i i rte' � /.I • I,/ CONTRACTOR LICI: CONTRACTOR: MAILING ADDRESS: PI.UMBBING INFORMATION' N MECHANICAL INFORMATION CONTRACTOR LIC j : 17-71210:06(17;73,06961 F74? Co 6E /I-6 EN «EN iC2, MAILING ADDRESS: Y ELECTRIC: GAS: OIL: CCAL: WOOD: I SOLAR: HEAT PUMP 'CONTRACTOR: ENERGY CODE: WSEC: NWEC: 521 - UTILITY: SGC: APPROACH> PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: s.:::::::::::::::::::::::::::::::::**2:::::::::::::::::::::::::::::::::**** ._ MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION PROCESSING FEE DUCTWORK SYSTEM NUMBER OF YES OR NO WOODSTOVE/INSERT( Za.6 GAS WATER HEATER GAS HTG EQUIP(100,000)BTU GAS HTG EQUIP +100,000 GAS PIPING -1 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 ?_.FRIG 101-1750 BTU .:EFRIG +1750 BTU--- AIRCONDITIONER-0-3 HP AIR=C-ONDITIONER 3-15•HP -. AIR-CONDITIONER-15-30:J1P_ ?IR CONDITIONER 30-50 HP AIR CONDITIONER +50 HP VENTILATING FANS EVAPORATIVE COOLERS. MOODS -_ • :LOTHESLDRYER, =i • .;A5 -LOG JNLISTiD GAS APPLIANCE 4IR I{ANDT. ER 1-10000 CFM ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS BATH TUBS KITCHEN SINES DISHWASHERS GARBAGE DISPOSAL CLOTHES WASHER UTILITY SINKS ELECTRIC WATER HEATERS FLOOR DRAINS FLOOR SINKS BAR SINKS ROOF DRAINS LAWN SPRINKLER— SEWAGE-EJECTOR-.. PRINKLER'SEWAGE.EJECTOR-.= WATER SObTENER URINAL DRINKING FOUNTAIN°'= NUMBER OF YES OR NO = !.