1988, 10-07 Permit App: 88003131 Wood Stove INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: _J(
CITY/STATE/ZIP: C/ :eif,.[4 257).7
SUBDIVISION:
BIOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
p OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE: J-/19 -- T27- /eAc
MAILING ADDRESS:
CITY/STATE/ZIP:
1) 1
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: —
i ,
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: -
MAILING ADDRESS:
ARCHITECT/ENGINEER: - PHONE: - -
MAILING ADDRESS:
NEW: REMOD ADDITION: E OF USE:
DWELL UNITS: •' *ANT LOAD: BUILDING HGT: STORIES: '
• BUILDING DI IN ONS: X (WIDTH X DEPTH) Si . FT. :
• REQUIRED PARKING: f HANDICAP: SEWER (Y/N) : HYDRANT:
PLUMBING INFORMATION
CONTRACTOR LIC# :
N
CONTRACTOR:
MAILING ADDRESS: / \
***************************************************************************
MECHANICAL INFORMATION
CONTRACTOR LIC# / — / �- L C% � C / r" / 1 C
CONTRACTOR: I- / 7'L (
/-74-L ` e ti ��_ V
MAILING ADDRESS: H' —"W(�, ��I C (�f E^ � �, _(J-7 7iC1c
y t
ELECTRIC: GAS: OIL: CCAL: WOOD: 2( SOLAR: HEAT PUMP
ENERGY CODE: 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 f 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
R.: FRIG 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