1990, 09-06 Permit App: 90004429 Pellet StovePARCEL NUMBER:
INFORMATION WOR SHE,;T
i k -1rics
STREET ADDRESS : 4 Ot VC\
CITY/STATE/ZIP:_ \� �At'\
SUBDIVISION:(t)4k)
BLOCK: 1 LOT: 6 ZONE: A DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: /C/ R/W:
OF BUILDINGS:
Ort'idER :
OF D'.7ELLINGS: WATER DISTRICT:
PHONE:'S(CA
MA]:LING ADDRESS:
CITY/STATE/ZIP:
C'U; 11'ACT:
SETBACKS: — FRONT:
I is:M1 T USE:. __
LETT:
PHONE:
RIGHT: RFJ-R:
*x*x*x*xxxsxxxxxxxxxxxx*x*******x*****x*x*x******,,,
I3II1LDING 1Nr'ORN.ATION
•
:d';'R1,C:Tor I.IC1-NNSE 1:UM13ER:
1•;7,1 LI NG /,1)I)12F::; ;:
;» 'C:uITELT/ENGINEER:
11?,I LI NG AUUREsS:
PHONE:
PHONE:
:1-14: KDiODEL: ADDITION: CHANGE OF USE:
I,e;i:LL UNITS: OCCUPANT IOAD: BUILDING HGT: STORIES:_
1',UI LDIT:G I)11?1-?lSIO:Z S:
1J? JI 12F:D FARF:ING:
X
t HANDICAP:"
(WIDTH X DEPTH) SQ. FT.:
SEWER (Y/U) : HYDRANT:
7'.4vaiaeJ Je.ezXld
CD:l'i'RACiti'R I,I , 1
CONTRACTOR:
MAILING ADDRESS:
r
s::****************::*****************&**********************************
MECHANICAL INFORMATION
CONTRACTOR LIC # : _ _FItu o L / 7JZGC
FiCz co eA .p . NrE -� d -
E .93M $e",f 15: ;' S,b4,9,i'E £)9:F9.�a� '
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC: GAS: OIL:
ENERGY CODE: WSEC:
CCAL: HOOD: SOLAR: HFJ%T PUMP
NWEC:
UTILITY:
SGC:
APPROACH PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
x x t f 31 1 * * * * * * * * * * * 1 *tick * * * * * * * * * * * * 1 1 * * * * * * * t * * * * * * * * * * t t = * * * * s * * * * t * * x * * t * *
MECIil.NICAL FEES
1 'i'i•.M I )ESU}2I PTI ON
'ROC ESS I NG FEE
• ic'i'er )RK SY:,'1'}•:M
)I):;7`3VE/ I I:::} -.PT
7. WATER i':R HEATER
..; }i"1'G }:QU1P(100',000)BTU_
11'1'G EQUIP -1100,000
.;AS PIPING - t OF UN] TS
HEATI'UMP 1-100 }3TU
fiEATPUMP 101-500 liTU
:AT}'UI•iP 501-1000 13TU
ii ATPUMP 1001-1750 I3YU
' 1-:l..`1'PU1- P +3751 I3'I'U
''-'rtIG 1-100 }3'111
:FP IG ] 01-500 13.111
•:}.•1; IG 501-100 BTU
'1:Fk1G 101-1750 13TU
IG -11750 I3TU
P. CONDI T1ONER 0-3 HP
R CONDITIONER. 3-15 HP
l R CONDI TIONER 15-30 IiP
I R CONDITIONER 30-50 HP
.1 R CONDITIONER +50 IIP
•'1.!:TI LAW NG FANS
2VAPORAT1 VE COOLERS
!/J111ES DRYER
AS If )C3
'N1.1!;TED GAS 1,1'PI,I).NCE
',1}? ,•n:I)I,I:R 1-10000 C1714
NUMBER OF
YES OR NO
PLUMBING FEES
ITEM DESCRIPTION NUMBER OF
PROCESSING FEE YES OR NO
`10I LEIS
SI NKS
: ;i3CY ERS
TUBS -
K] TCHEN SI NRS - _ ---
D] S 'BIWA ?ERS
GAPBAGE DI SPOL;AL
CLOTHES hA SIIER
UTILITY 51 NKS
ELEC'1'RI C WATER HEATERS
FLODR PRAINS
FLODR "SI U}:S
I3 AR SI N K S
ROOF DRAINS
1.AWN SPRINKLRR
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN