1991, 01-07 Permit App: 91000065 Pellet Stove,
SIP
PARCEL laMBER:
ETRE ET ADDRESS: 991 l 1 S. Res C� .
I1:'r'Oiv"1,T1 ON WORKSHEET
• ▪ .
CITY/STATE/ZIP:-foDtcurN9._ ) �' �� c2DCQ
sUliriIYISION:.•
FLOCK:' LOT:
I,CTT Al:EA: F/A: WIIY11i: DEPTH: R/W:
OF BUJ
i.UINGS: -j-€ OF DWELLINGS:. ' WATER DISmTRICTT:__ --..�::}t: 7\ l Cil 0ll l Ctb% P11D::E:_� Vq -4‘(:)‘5 59 U12
ZONE: DISTRICT:
?A]1.ING ADDRESS:
1'J'Y/::T/:1'E/ZIP:_
-
11:11:1'1' U:;E:
P11017E :
BUJ LI)7NG I1:'r'OR AT'307:
':').`).C'J\")R 1.ICPJ: r. NUMBER:
EA] 1.) NG Al iUN12;n:
PHONE:
1.;r:i11Trine/ EIJGINEER: ' -^ . PHONE: _
I;.'.1 1.1 NG ADDRESS:
NEW I.EMODET.: ADDITION:_ CHANGE OF USE:
1'e1:I.T. I:::J',':: CGCCUPANT Jfl1D: DUI I.DI14G HGT: SIORIFS:_
1'.U11.)J1:G 1111:}:!7::IO:S:_ Y. (WI Drill ): DEV'iTi) SQ. FT.:__
1,17.):1I v1:1) 1'/.1:1: 1)1G:
1 IUJiDICAP: I -E ER (Y/N):
11YDRAlr f:__
CONTRACTOR:
NAILING ADDRESS:
silrrrrrrrirlrzrsirtirriiirrrrrirrrrrsrrrlsirs::ir:::::rsi:tirsr:::::r11r
MECHANICAL IFFFORM1TION
CONTRACTOR LC!:
_p / L ad e/_it�jewiCv�e AA
COJ: Ith
'iCiOR: ��G CD er/epey ra4 .
SAP/cafe: I, s*4'/T#IC £),9 c 2
MAILING
ELECTRIC:___ GAS:, OIL:_ CCAL:
ENERGY CODE: WSEC: tr)7EC:
WJJD: /\ SOLAR: HEAT PUMP
UTI 1,1'iT:
SGC:__
APPROACH> PRESCRIPTIVE: POINT: _ COMPONENT: SYSTEMS:
1**** t r i 1 2 i i 1 s 1 i i 2 1 1 1 1 2 1 1 i i i L i* i i 1 1 1 1 1 1 1 i 1 1 i 8 i 1: i i 1 i i i i i 1 i i r i 1 1 i i 1 i i i 0 i i i x i.
MECHANICAL FEES
!TEM U I;SC_i:1. P1'I ON ----
-RUC 1:SS1UG FEE
IC:'.:. )12K :;Y:,'i') _1.
:'J):.'J-) 1:/ 11::'.r.i:'T
"! WATER HEATER
HT ; }7`)UlP(100,000)HTU
?S 1IJ'G F:;)UIP 1100, 000
:;AS PIPING - f OF UR 1 TS
HE I'i'Ut?3' 1-300 BTU
H E.Vi'i'UMP 101-500 )3TU
;i;: ATI'UMP 501-1000 )J'1'U
i:AJ'J'IJMP 1001-1150 BTU
'>:F'J'J'I1MP 11151 BTU
CERJ(; 1-100 mu
:ri'IG 101-500 I;TU
•:f'FIG 501-100 BTU
,';:Fi<IG 101-1750 BTU
::)'RIG 11750 11'J'U
NUMBER OF
YES OR 170
!P CONDITIONER 0-3 1)P
'N COND1T1C'!;I:R 3-15 HP
IR CONDITIONER 15-30 11P
1P CONDITIONER 30-50 HP
-IR CONDITIONER 150 13P
.j.!.'J J LA'J'J 1:G VANS
}:'.7,1•:);'A'1'1 V;: GOOLE;:S
!/Ji iif?S
1)YER
/-.!::,E
'AS Ii>•3
i'NI.1 !:i'1:1) (:1.; APPLIANCE
'.1 R I. !;i'l.!:;t 1 - 1 0000' c'1 "1;
PLUMBING FEES
ITEM DESCRIPTION NUMBER OF =
PROCESSING FEE
'JOT I.E'rS
SINKS
::HO E:3S
E?,ii3 TUBS
KITCHEN SINKS
Dl ;ir i ci;i:RS
GARBAGE DISPOSAL
CIIil'HES WASHER
UTILITY SINKS
ELECTRIC NATER HEATERS
FIIJDR DRAINS
1'1lDJR 'SINKS
HAP sl rrs
RODE BRAINS
1.? N SPRINKLER
Sl74AGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOU)rI'AIN
YES OR NO