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1989, 07-24 Permit App: 89002374 Pellet Stove S INFORMATION WORKSHEET PARCEL NUMBER: 3 D-5 �' – a ---7 STREET ADDRESS: ic,s7• /0 7 �r,f JZ c/er/a n Pr - CITY/STATE/ZIP: ,C-C(n e coi9Z:20 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: OF BUILDINGS: f OF DWELLINGS: WATER DISTRICT -� OWNER: 10, / 40 . / 4 -- PHONE: ��9 - - F''39 MAILING ADDRESS: cS4/Ate CITY/STATE/ZIP: CONTACT: PHONE: - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: _____ x ! ** x x x x ** * ** *x* *x x x *************x ***x*********x***************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: —_ .CONTRACPOR: 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: t HANDICAP: SEWER (Y/N) : HYDRANT: e / t , , _ • ,-,il__/ ' }/''!—:'�� ..e,>4.:x .•/// '-1ll.<_-%I<-%, 4__,_4/ K P, LIC# CONTRACTOR: NAILING ADDRESS: ************************************************************************* MECHANICAL INFORMATION CONTRACTOR LIC# : F/9. L 2-2 C / 7J,73/ CONTRACTOR: .L �J fiA72 G!G, ' 7 y ',- -�-Y MAILING ADDRESS: A512 SY/ , r.$/%1-7/Ve 17: /7 ELECTRIC: GAS: OIL: CCAL: WOOD: X SOLAR: HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH PRESCRIPTIVE:_ POINT: COMPONENT: SYSTEMS: MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION NUMBER OF ITt` I DESCRIPTION NUMBER OF 'ROCESSING FEE YES OR NO PROCESSING FEE YES OR NO J,p � C�TWORK SYSTEM TOILETS 0VE/INSERT X - SINKS -- WATER HEATER SHOWERS 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 I3TU Cl/JTHFS WASHER HEATPUMP 501-1000 -BTU _ UTILITY SINKS HEATPUMP 1001-1750 BTU ELECTRIC WATER HEATERS IEATPUMP +1751 BTU _ FIOOR DRAINS EFRIG 1-100 BTU _ FLOOR SINKS ___ :FRIG 101-500 BTU I3AR SINKS EFRIG 501-100 BTU ROOF DRAINS REFRIG 101-1750 BTU _ LAWN SPRINKLER l.EFRIG +1750 BTU SEWAGE EJECTOR IR CONDITIONER 0-3 HP WATER SOFTENER TR CONDITIONER 3-15 IIP URINAL :IR CONDITIONER 15-30 RP DRINKING FOUNTAIN IR CONDITIONER 30-50 HP '.I R CONDITIONER +50 HP 72ITILATING FANS APORATIVE COOLERS 70DS `LOTHES PS DRYER ANGE AS LOG NLISTED GAS APPLIANCE IR HANDLER 1-10000 CFM