1988, 07-19 Permit App: 88001973 Re-Roof INFO1LMATION WORKSHEET
PARCEL NUMBER: /15554 — 1 1 13 ee,- 1g73
STREET—ADDRESS: E 1 9 D D '1 P. t u er 5.1 d e„
CITY/STATE/ZIP: �Jpn kaon e E W A. 4370 11,
SUBDIVISION: /
��(T M-�( E A LLE-J vl G./_v 5T u .
BLOCK: -7 LOT: 113 ZONE: AS DISTRICT:
LOT AREA: I/C F/A: WIDTH: 8 / DEPTH: //./cj R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: .1)phaUX -C• Kruger PHONE: SO'? - -
MAILING ADDRESS: EI900g �versic� �
CITY/STATE/ZIP: 5Pok atie / 14._) A 9 ca.o Iv
CONTACT: Anima ZAjise, `N NI"e' er5 _Inc.,c., PHONE: Sol - 4 a tt — C 9 7
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: co r p e, root�J
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BUILDING INFORMATION 57/389
CONTRACTOR LICENSE NUMBER: WISE N MI 1.12, kW
CONTRACTOR: Lii t s e. `N M ey er s -The . PHONE: So/ - O a 17
MAILING ADDRESS: `r . r t^ • . _ 4. ' -2 -
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 (Y/N) : HYDRANT:
Revised 1/88
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CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
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MECHANICAL INFORMATION
CONTRACTOR LIC#: '
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC: GAS: OIL: CCAL: WOOD: SOLAR: HEAT PUMP
ENERGY CODS.: WSEC: NWEC: UTILITY: SGC:
APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
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MECHANICAL FEES PLUMBING FEES
ITEM DESCRIPTION NUMBER OF ITEM DESCRIPTION- NUMBER OF
PROCESSING FEE YES OR 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 HP
VENTILATING FANS
EVAPORATIVE COOLERS
HOODS
CLOTHES DRYER 0,00
RANGE
GAS LOG lid
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM
AIR HANDLER 10000 CFM