1988, 10-24 Permit App: 88003209 WoodstoveINFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: v S IV T 0
CITY/STATE/ZIP: O k O` NA P-- w.A
SUBDIVISION:
BLOCK:
LOT: ZONE:
DISTRICT:
LOT AREA: F/A:
WIDTH:
DEPTH: R/W:
## OF BUILDINGS: #
OF
DWELLINGS:
WATER DISTRICT: I ' 0� R ►V
OWNER: �.0
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PHONE: - 06 -
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S� N T o
MAILING ADDRESS:
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CITY/STATE/ZIP
CONTACT:
PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE: - -
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#: ,
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MAILING ADDRESS:
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MECHANICAL INFORMATION
CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC- GAS:
ENERGY CODE: WSEC:
OIL: CCAL: WOOD: SOLAR: HEAT PUMP
NWEC: UTILITY: SGC:
APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
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MECHANICAL FEES
ITEM DESCRIPTION NUMBER OF
PLUMBING FEES
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-i00 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