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1988, 11-01 Permit App: 88003524 Furnace, RangePARCEL NUMBER: INFORMATION WORKSHEET. STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT AREA: 0,C\'\),Ai0 '4)6 LOT: F/A: ZONE: DISTRICT: WIDTH: DEPTH: R/W: #.OF BUILDINGS: 1 # OF DWELLINGS: WATER DISTRICT: OWNER :SSC � MAILING ADDRESS: yo CITY/STATE/ZIP: CONTACT: )211.416cti 0 (6k PHONE: ;4 c,4_ (Y1( .A 4 SETBACKS: — FRONT: LEFT: RIGHT: REAR: PHONE: PERMIT USE : cri !r CONTRACTOR LICENSE NUMBER: CONTRACTOR: c„, a ak lc I4- ,tip BUILDING INFORMATION 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.: f HANDICAP: SEWER (Y/N): HYDRANT: CONTRACTOR LIC#: CONTRACTOR: PLUMING 1NFO1MATION MAILING ADDRESS: *************************************************************************** MECHANICAL INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: ELECTRIC: GAS: OIL: CCAL: WOOD: SOLAR: HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: *************************************************************************** MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION PROCESSING FEE DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER GAS HTG EQUIP(100,000)BTU GAS HTG EQUIP +100,000 GAS PIPING - # 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 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 ATR ImmTvum, 1 nnnn nw r NUMBER OF YES OR NO ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS 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 NUMBER OF YES OR NO s