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1988, 12-02 Permit App: 88003882 Inserts 1 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: / /94x./ s/e2 a J CITY/STATE/ZIP: �/c>�. QG2�« e.J 99e)&7 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: 4 OF BUILDDINGS: f OF DWELLINGS: WATER DISTRICT: OWNER: C Q�/� �/ � 4 � PHONE: 1:5,49- �7 4 MAILING ADDRESS: CITY/STATE/ZIP: ICt" CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: L-Pz1�1JFZJ ,1� lelee **xxxx*************x**************************************r*r****************r BUILDING INFORMATION COli RACTOR LICENSE NUMBER: - CONTRACTOR: - PHONE: - MAILING ADDRESS: ARCHITECT/ENGINEER: PHONE: - - MAILING ADDRESS: NEW-: REMODEL: ADDITION: . s . E OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: . a BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. : REQUIRED PARKING: f HANDICAP: SEWER (Y/N) : HYDRANT: PLUMBING INFORMATION . CONTRACTOR LICE : CONTRACTOR: \ MAILING ADDRESS: **************s************************************************************ /MECHANICAL /INFORMA^TION CONTRACTOR LICE: / -7/ C_. 06 C ! 73 /VJ CONTRACTOR: F--/17 ( (9 ( J 4 fL.D CN (1)&1/7-LW, /WC_ V C MAILING ADDRESS: /r S,9r.-0 e y ✓ i 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 ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO PROCESSING FEE YES OR NO DUCTWORK SYSTEM TOILETS WOODSTOVE/INSERT ) 1 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