1988, 10-07 Permit App: 88003130 Wood Stove r
INFORMATION WORKSHEET
PARCEL NUMBER: 2 - '`7/1-
STREET
1-STREET ADDRESS: 4/) Ii
CITY/STATE/ZIP: ,i i / 1903 7
SUBDIVISION: C�(Z-� f2.5 ADO
BLOCK: 2 LOT: ll/ ZONE: te" DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
f OF BUILDINGS: f OF DWELLINGS: WATER DISTRICT:
OWNER: ZZ2Z,.4x.../ L�� PHONE: L5"D f— -
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR . CENSE NUMBER: -
CONTRACTOR: PHONE:.- - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REDEL: ADDITION_ CHANGE OF USE:
DWELL UNITS: / OCCUPANT LOAD: BUILD G HGT: STORIES: '
BUILDING MENSIONS: X (WIDTH X ,EPTH) SQ. FT. :
RE RED PARKING: it HANDICAP: SEWER (Y/N) _ HYDRANT:
PLUMBING INFORMATION
CONTRACTOR LIC# :
CONTRACTOR:
MAILING ADDRESS: N
****:********************:************:***:******************:*************
MECHANICAL INFORMATION
CONTRACTOR LI C I: / �"i C ` C l t 6
CONTRACTOR: `" /�L C` i ( 'i";j �' �I �`
MAILING ADDRESS: /! l % i l 7 l
r• r
ELECTRIC: GAS: OIL: CCAL: WOOD: A' 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 +100,000 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 .'
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM