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1989, 11-13 Permit App: 89004635 Pellet Stove
I I;r•ORMA TI -,ON WORKSHEET PARCEL NUMBER: STREET ADDRESS : /X.14,V CITY/STATE/ZIP: J�`Li�7"" ) SUBDIVISION: BLOCK: F: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: OF BUILDINGS: O N ER : MAILING ADDRESS: € OF DWELLINGS: WATER DISTRICT: CITY/STATE/ZIP: CONTACT: PHONE:�1r L-��`�` - ‘J-77 SETBACKS: - FRONT: I:i:Ii1 T USE: LEFT: PHONE: RIGHT: F. EAR: 1 2 1 X 1 1 1* 1 1 2 2 1 ....... 2 2 2 2 1 Y Y 2 2 X 1 2 Y 2 2 7r ** t 2 Y 2 2 2 1 Y X Y 2!* Y :+TR) CTOR LIC'rI:SE NUMBER: I3UI LDING 1 I:'r'ORMATI ON C UN1'RACjOR: PHONE: •;7,1 1.3 ?. G A1)Di2ESS : 1 TEC"1'/ENGINEER: .1 I.I NG ADDRESS : NEW:_ RF-:21ODEL: ADDITION: MANGE OF USE: `-EI.L UN7'1'S: OCCUPANT LO1D: BUILDING IIGT: STORIES: . *UT I.DIi:G U1l??:NSIO:.S:_ X (WID'TH Tt DEP'l'FI) SQ. FT_: PHONE: '1 -:QUI PED i•ARI;ING: / f 11111IDICAP : Jae.i-e} 4,06062 SEWER (Y/N) : I IYDRANT: ,.'i0.L CUh:i2AC. 10R: -- MAILING ADDRESS: *******t***ttt**t*****t**ttt***t**t**i*****t******:stats****t*s*sst*stt* CONTRACTOR CONTRACTOR: MECHANICAL INFORMATION E/9464 egipE INkILING ADDRESS: Z . r ,_SAW94/E 449 _994f2e4 t r ELECTRIC: GAS: OIL: ENERGY CODE: WSEC: CCAL: WOOD: / SOLAR: HEAT PUMP NEC : UTILITY: SGC: APPROACH:, PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: c , , * : * * * * * * * * * * * * * * * * * * * * * 1 * * * * * 1 1 * * * * * i * * ! f * * * * * * * * * * * * * * * * 2 * x t t * * x t * 2 * t MECHANICAL FEES M I )ESCIl I PTI ON ►::: ESS1NG FEE :1',' )RK _;1'_;'1'Ei 01-: UVE/INSERT WATER HEATER HTG EQUIP( 100, 000) I>7'U II'1'G EQUIP +100,000 PIPING - OF UN' TS MP ,TPU MP ,'FI'UI AP ,'I'i'tJMP 1-100 BTU 101-500 I3YU 501-1000 BTU 1001-1750 BTU +1751 BTU 'PIG 1-10 0 BTU TIG 101-500 BTU TIG 501-300 BTU 'i<IG 101-1750 BTU TIG 41750 BTU CONDITIONER 0-3 RP CONDITIONER 3-15 HP CONDITIONER 15-30 HP CONDITIONER 30-50 HP CO':DITI.ONER i50 IIP 1'IIIJ,TING FNS ..':?i'ATI VE COOLERS Iii•:Y}:R r,, PPLI).':(2E .. * N14./32 1-10000 ci 7! NUMBER OF YES OR NO PLUMBING FEES ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO TOILETS SINKS SHOWERS — BATH TUBS -- KITCHEN SINKS DISHWASHERS G1JPAGE DISPOSAL CLOTHES WASHER U'I'ILITY SINKS — - ELEC1'RIC WATER HEATERS i:'I,OOR DRAINS — — I'ITOR .SINKS BAR SINKS ROOF DRAINS I2:.,74 SPRINKLER SEWAGE EJECTOR WATER SOFTENER URINAL DRINKING FOUNTAIN