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1990, 04-12 Permit App: 90001394 Insert
INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: /\j , 41 ( 01--) CITY/STATE/ZIP: � LC) _N"\ � IL�,_�c,_�, , ci i63 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: ( > PHONE: ?50"-t — 9,2E— eoLic ..S MAILING ADDRESS: � • )/ C1 U `� E) .f ' td CITY/STATE/ZIP: � y - � > .) V, )C) . , / G� CONTACT: ,s3 PHONE: 09 s ! L/g SETBACKS: — FRONT: LEFT: RIGHT: REAR: PERMIT USE: Q_X' .c C. C' c' **********************************.**********************************x********* 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: X (WIDTH X DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER ,(YIN) : HYDRANT: V PLUMBING INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: xxx*******x****x*********************************************************** MECHANICAL INFORMATION CONTRACTOR LIC# : )O P1 ,(v(_. 01, 9 CONTRACTOR: '� .� ° l IrYI, e 4 MAILING ADDRESS: c_›/ , 1 ?)(-)(., iL_ (�C) nQ. Lk)4 . 92 7O()- ELECTRIC: GAS: OIL: CCAL: WOOD:✓ SOLARt�� : HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: ****xxxxxxx***********************xxx**xxxxx***********x******xxxx*******x* MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION NUMBER OF ITEM DESCRIPTION NUMBER OF PROCESSING FEE &S3OR NO PROCESSING FEE YES OR NO DUCTWORK SYSTEM TOILETS WOODSTOVE/INSERT ( SINKS GAS WATER HEATER SHOWERS GAS HTG EQUIP(100,000)BTU BATH TUBS GAS HTG EQUIP +100,000 KITCHEN SINKS GAS PIPING - # OF UNITS DISHWASHERS HEATPUMP 1-100 BTU GARBAGE DISPOSAL HEATPUMP 101-500 BTU CLOTHES WASHER HEATPUMP 501-1000 BTU UTILITY SINKS HEATPUMP 1001-1750 BTU ELECTRIC WATER HEATERS HEATPUMP +1751 BTU FLOOR DRAINS REFRIG 1-100 BTU FLOOR SINKS REFRIG 101-500 BTU BAR SINKS REFRIG 501-100 BTU ROOF DRAINS REFRIG 101-1750 BTU LAWN SPRINKLER REFRIG +1750 BTU SEWAGE EJECTOR AIR CONDITIONER 0-3 HP WATER SOFTENER AIR CONDITIONER 3-15 HP URINAL AIR CONDITIONER 15-30 HP DRINKING FOUNTAIN AIR CONDITIONER 30-50 HP AIR CONDITIONER +50 RP VENTILATING FANS EVAPORATIVE COOLERS HOODS CLOTHES DRYER RANGE GAS LOG UNLISTED GAS APPLIANCE