1990, 02-21 Permit App: 90000607 Insert INFORMATION WORKSHEET ' 1
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•
PARCEL NUMBER: - . 0°r. pr
STREET ADDRESS: II • i\i _ Ilku •yi
CITY/STATE/ZIP: lb. ti.� _ + • • ` ' • • -
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W: •
f OF BUILDINGS: € OF DWELLINGS: WATER DISTRICT:
OWNER: <i,& \, c�SC\Z`,_6- PHONE: _- -C�� -
TLAI LI NG ADDRESS: M
c
C ITY/STATE_/ZIP: — -
CONTACT. PHONE: -
SETBACKS: - FRONT: - --
LEFT: — RIGHT: PEAR:
I i:EVA'T U`;F_ -- '_ � ----
. . t x t **t t *t,***t*t t***t t**X****tit****t** t*******t.t t
13U I LDI NG 1NFORMAT I ON
:4TRAC'POR I.ICENSE NUMBER: - —
C'ON'1'JU C'711R: PHONE: - - _
•
NAI 1.1 NG ADDI2E:;S: — — _ ___
7'r?CiiITECT/ENGINEER: PHONE: . - -
r._,-.1 I.1 NG ADDRESS:
1:i-:4: REMODEL: ADDITION: CHANGE OF USE:
I:-WE .L UNITS: OCCUPANT IDAD: BUILDING HGT: STORIES: '
I'UII.DI t:G Di V.1-:.14:-;IONS: X (WIDTH X DEYTFI) SQ. FT_ : .
I;EQU I I?}:D 1:AR}:I N G: - € HANDICAP: SEWER (Y/2t) : HYDRANT:
CO:-/TRACTOR LI C$ :-- _ _ -._ ___--
CONTRACTOR:
MAI LING ADDRESS: \ V •
************************************\*******:**************************
MECHANI CAL INFORMATION
CONTRACTOR LIC# : L • �J .
CONTIthCTOR: /C'C O eg40:78 • /
MAILING ADDRESS: £ 9NO . .,/eRelie. -- ' 45497#11 449- 9f 0-
t
ELECTRIC: GAS: OIL: CCAL: WOOD: SOLAR: HEAT PUMP
ENERGY CODE: WSEC: NWEC: UTILITY: SGC:
APPROACH:, PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
i f 1 1 1 Y Y 1 Y Y**t Y Y t Y 1 *Y Y 1 Y 1 Y Y Y Y*i t i 1 i Y t Y Y t Y Y 1 1 1 1 Y Y*Y i t**i*Y Y i *Y Y*2 1-1 1 Y t*i i *
MECHANICAL FEES PLUMBING FEES
'EM DESCRIPTION NUMBER OF ITEM DESCRIPTION NUMBER OF _
OZI:SS1NG FEE YES OR NO PROCESSING FEE YES OR NO
)RK ,SYSTEM 7vI LE`I'S
) )_"POVE/I1:S}•:}:T SINES -- -
- �;h`1'}.R HEATER -.--- -- - ;:iiJ'riEKS ------
liTG EQUIP( 100, C,00 )1> 11 1?','iii TUBS
.S II'PG EQUIP 4-100,000 KITCHEN H1':N SINES
S PIPING - t OF UNITS S DISHWASHERS - -
.`I'i'UMP 1-100 I3TU GAEBAGE DISPOSAL -
k`I'PUMP 101-500 Ii71I CILi HF_S WASHER -
.ATPUMP 501-1000 BTU - UTILITY SINKS
_A` PLIMP 1001-1750 I3TU ELECT'RIC WATER HEATERS - - -
:AT1'UMP +1751 I3TU FI1JR DRAINS __-
-
IG 1-100 BTU FI IDDR SINES
.r}'IG 101-500 13'111 BAR SINES
501-1 00 I3TU ROOF DRAINS
NS
.1k1G 101-1750 13Th - -- LAWN SI'RINKLF_R
.FRIG 41750 I3TU SEWAGE EJECTOR
I? CONI)1'1'IONER 0-3 HP WATER SOS TENFR
--
R CONDITIONF-R 3-15 HP URINAL
RCONDITIONER 15-30 HP I)RINIUNG FOUI<rAIN
R CONDITIONER 30-50 HP
R CONDITLoNE . +50 IIP
_
.':TIIJ,TING FANS _
APORAl'1VE COOLERS
DRYER
CAS APPI,II' ::E - --
H Ei.' `:i)I.1:R 1-10000 ('}"1! - - -