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1989, 01-18 Permit App: 89000110 WoodstoveINFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: / y/cy z .5 06- ypit,oi CITY/STATE/ZIP: J� Yo (,.) 15 N 14. cj l O ,2) T 5 Z1 (p SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: * OF BUILDINGS: / 1 OF DWELLINGS: WATER DISTRICT: OWNER: /Aim/ .1 G Q Lt. 6 /r t% 5 PHONE: S-6)`? _70Z - I1 y MAILING ADDRESS: / L/. 'Z 3 C t y ywf , CITY/STATE/ZIP: 3Q 0 KCe ) - /4 1 n 5 1-0 it/ %Z / l' CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: PERMIT USE: �'_L4-€ i 5 TO U ****************************************************************************** 1- 4'57HL-r97-;a,4J ;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: X (WIDTH X DEPTH) SQ. FT.: HANDICAP: SEWER (Y/N): HYDRANT: Revised 1/88 CONTRACTOR LIC#: CONTRACTOR: 1-1 11J ya•v .a 11.11a. vi�11<>11 Vag MAILING ADDRESS: *************************************************************************** MECHANICAL INFORMATION CONTRACTOR LIC*: CONTRACTOR: MAILING ADDRESS: ELECTRIC: GAS: OIL: ENERGY CODE: WSEC: CCAL: WOOD: SOLAR: HEAT PUMP 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 GASHTG 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 EFRIG--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 FEES _: ITEM 'DESCRIPTION _ _ _ ... -NUMBER OF PROCESSING FEE ..YES OR NO TOILETS.. SINKS BATH ,TUBS KITCHEN SINKS -' .. 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