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1989, 02-06 Permit App: 89000243 Furnace, Piping INFORMATION WORKSHEET PARCEL NUMBER: W5-3/ — Q-11 / STREET ADDRESS: ( O / CITY/STATE/ZIP: SUBDIVISION: ( ARbA\1G- BLOCK: LOT: ZONE: AS DISTRICT: LOT AREA: 249Y ) F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: e OWNER: 4/) ite,,cji24-4-z) PHONE: - - MAILING ADDRESS: 710 CITY/STATE/ZIP: CONTACT: of e A-67, 5 � �f �� 'V► PHONE: - 3.)7 - 3 :� SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** 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 (Y/N) : HYDRANT: PLUMBING INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: *************************************************************************** MECHANICAL INFORMATION CONTRACTOR LIC#: ( s'l9 ot,r `f CONTRACTOR: //(2/11-',A(..5 MAILING ADDRESS: GSL/ . ( !n2 C) 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 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 +100,000KITCHEN SINKS GAS PIPING — # OF UNITS V 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 RANGE GAS LOG UNLISTED GAS APPLIANCE AIR HANDLER 1-10000 CFM AIR HANDLER 10000 CFM