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1987, 05-28 Permit App: 87001517 MH****************************************************************************** * INFORMATION WORKSHEET 'j * ****************************************************************************** * PARCEL NUMBER: 06155 2 —10i ( • STREET ADDRESS: 5 (a S ()A GA\MO V')1 * CITY/STATE/ZIP: 0115 Ol't+r,OS. u0 - 9 U 2 7 * * SUBDIVISION: r5 ✓ n1 0 0 t,'i.0 4-alI C. f ff * BLOCK: ( LOT: I i ZONE: P.01-1 DISTRICT: 6 * LOT AREA: F/A: WIDTH: DEPTH: R/W: * * * # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: * * * * OWNER: Motel AY!vl Je-rikin+ PHONE: - 3,5--.3R4-s * * * * * * 1 * CITY/STATE/ZIP: p0 k 0.ryik.. A 1�%�' 9 � a ,* * CONTACT: rn dit n _02,r. [.Q a PHONE: -3 A5? -1'27 * * * * SETBACKS: - FRONT: LEFT: RIGHT: REAR: * * 7-$ rX o• ' 2o' 3o ' (F -A -k- G,xlcs * * P$RMIT USE: MO6 i'; -thv 1e it ici f a -c.44- 'L 644' A- E <�l r.,---4\00T6`0"''be m) * * MAILING ADDRESS: S a.,‘ 0Ve rt3 c,cy,1 , a 3v� ****************************************************************************** * BUILDING INFORMATION * * * * CONTRACTOR LICENSE NUMBER: * * * * CONTRACTOR: PHONE: - - * * * * MAILING ADDRESS: * * * * ARCHITECT/ENGINEER: PHONE: - * * * * MAILING ADDRESS: * * * * NEW: REMODEL: ADDITION: CHANGE OF USE: * * * * DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: * * * * BUILDING DIMENSIONS: * * REQUIRED PARKING: ********(*************************** **************** ** **** ************* <_ ` 0:74 X (WIDTH X DEPTH) SQ. FT.: * # HANDICAP: SEWER (Y/N): HYDRANT: * NGRILE 1 -CNE INFCRNATICt * CCNTR LIC#: * CONTRACTOR: PNCNE * * * MAILING ACCRESS : * * * PREVICLS ADDRESS: * * LOCATION: PARCEL I LNeER: * * * * STREET: * ; * CITY/STATE/ZIP:_ ' * MAKE: 57 r NCDEL_C;vw w -5 * SEPIALk: 1+IDTN: __ LENGTF:_� * ****,... .**t4444 4444*4**********************************t*****************t**- * RELCCATICN INFCRHATICI * * CONTR LIC#: * * CONTRACTOR: PFCNE:____-_.—_-_--- * MAILING AOCRE 5S: * PREVIOUS ACGPESS: _ * , • LCCATICN: PARCEL NUN@ER: STREET: * CITY/STATE/ZIP: * T ***********44g44*<;:********************************************************** * SIGN INFCRNATICN * CONTR LIC*: * $ * _ CONTRACTOR: F1 -CNE:____- - # * * MAILING ADDRESS * * * SQUARE FOOTAGE: - POLE HEIGHT: _ * * * * *********4******************************************************************** * DEMCLITICN INFCFNATIC 'f CONTR LICH: * * * CONTRACTOR: t FFiCNE: - - * * MAILING ADDRESS: * * * BUILCING SC&ARE FOCTAGE: * * NUMBER CF BUILDINGS: * * y y j j y y y y/ /{ y J y y y y J .-********************T****************************T***************1****** r -r r r t r r� ♦' a-+ t om'F V* V 4r 4 V: * PtuueInC 1NFCRMt,IGt #. CONTR LIC4: * * * * CONWRACTCR: P1C(vE: — — - * * NA1LING ACCFESS: * * * t * * t t * t t t t tai t t t * * Z # t * * * * * t * * * * * t * * * * * * t * * t t * * * * t * * * * * * # * * t * * * * t t * * * * r- * * * * * * * * * * MEiI-AN ICAL INFCRMATIGN *- * COPJIR LIC4: # * * CONTRACTGP : FFCnE : — — * # * MAILING ACCRESS: * t * ELECTRIC:_ CAS :___ CII :CCAL :___ * * #*t**tt*t*4#*##4444#t#**�t*t#vz*t**********************t*Y#tt#t###t#O#t#*#t-** ****************************************************+kik********************s** *** MECHANICAL FEES PLUMBING FEES IIE,M DESCRIPTION PROCESSING FEE DtJCTwORK SYSTEM aOCCSTCVE/IKSERT GAS wATER HEATER GAS HTG EQUIP<10C,000)BTU GAS NTG EQUIPf100.000 BTU GAS PIPING — !t OF UNITS NEATPUNP 1-100M ETU HEATPUMP 101-500N BTU HEATPUMP 501-1,000M BTU HEATPUMP 1,001-1750M 8TU HEATPUMP +1,750M BTU REFRIG 1-100M BTU REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REI -RIG . +1,750M BTU AIR CONDITIONER 0-3 HP AIR CONCITICNER 3-15 hP AIR CCNOI TIGNER 15-3C HP AIR CCNC.IT ICNER 30-50 HP AIR CONDI TI-GNER +50 HP VENTILATING FANS EVAPORATIVE CCOLERS HOODS CLOTHES DRYER RANGE GAS LOG UNLISTED GAS APPLIANCE AIR HANDLER 1-10000 CFM AIR HANDLER 10000+ CFM I\ (BER CF YES OR NG ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS EATti [UBS KITCHEN SINKS DISH WASHERS GARBAGE DISPCSAL CLOTHES HASHER UTILITY SINKS" ELECTRIC WATER HEATERS FLOOR GRAINS FLOCK SINKS BAR -SINKS ROOF CRAINS LAWN SPRINKLER SEWAGE EJECTOR WATER SOFTENER URNAL DRINKING FOUNTIAN r)Ccu eft NUMBER OF YES OR NG iv/ -6m 1 is • 1• E .s FPFof N_.;g 7/ ti • L6-01 /. c fC geS7.116 F