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1990, 10-24 Permit App: 90005627 Wood Stove INFORMATION WORKSHEET I I • (; I PARCEL NUMBER: a STREET ADDRESS: i .i. . .c. . 4P —7-1,, , .. / / J CITY STATE/ZIP: � a. UV4 -- I t q911 116 SUBDIVISION:_ BIOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: . ' OF BUILDINGS: DWELLINGS: WATER DISTRICT: L �(C��C/ L , I. I PRONE: ,. 2.°/_ _94.- 4k7P./, _ O:.'2:ER: ��.� t MAILING ADDRESS: \ C/ CITY/STATE/ZIP: PHONE: - - CONTACT: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: e6, W P066 Si A ', // �f SSSS ! ! + x * x * f * asxsa . : ,,,,***x**xx.:******** ***** ***********ft**************ia. BUILDING 11:FORMATION CONTRACTOR LICENSE NUMBER: – _ I'HC2dE: - - CONTRACTOR:R: MAILING ADDRESS: ARCHITECT/ENGINEER: PHONE: - - MAILING ADDRESS: , NEW:___ REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING IJGT: STORIES: . — BUIJ.DING I)IME17SIONS:_ X (WIDTH X DEPTH) SQ. FT. : REQUIRED 1'AI2}:I1tG: 1 HANDICAP: SEWER (Y/N) : HYDRANT:(-.7°- alalae) —.14, ' * . - – 1 GC�i ��C� CONTRACTOR 1,ICI : — --- Co1rI'RACTUR: FLAILING ADDRESS: \� * *.************************************i********************************** MECHANICAL INFORMATION CONTRACTOR LIC# : Joie CON'I'RAC IUR: p 94 co t,.7 gdepsi . - • MAI LI NG ADDRESS: E .7j76 _si&4974'i ELECTRIC: GAS: OIL: CCAL: WOOD: / SOIJ.R: HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH> PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: 11711xxx1xxlxx**1* * **** **xlxxx* xx111x1xx*xx1 ***x*x*xx*xxx•xx**xxx** xxx*xixx Ii Ed AH I CAL FEES PLUMBING FEES Ell I)ESC}n PTION_ _ _____NUMBER_OF_ ITEM DESCRIPTION NUMBER OF RO ESS1NG FEE YES OR 140 PROCESSING FEE YES OR NO '.IC'i.+ORK SYSTEM '101 LETS b�DS71)'JE/11:SE•:RT SI17E:S WATER HEATER • —_ -- :SHOWERS — - IITG EQUIP( 100, 000)13TU _ UAi7} TUBS ;1.S H'PG EQUIP +100,000 KITCHEN. SINES _ _ _-- ;AS PIPING - # OF UNITS __— DISHWASHERS _ iE1ti1'I'UMP 1-100 I3TU GARBAGE DISPOSAL - iE:ATI'UMP 101-500 BTU -----� CI/JTHES WASHER = _ _ iA1'I'UMP 501-1000 IITU UTI LI TY SINKS ii:1.TPUMP 1001-1750 BTU ELECTRIC WATER HEATERS 'E TP111.1P +3751 I3TU FLOOR DRAI NS ;:!-'141G 1-100 B'T'U YI/DOR SI11E:S :FPIG 101-500 I3TU I3AR SINKS -- ,:1•T 1 G — — ,:F'E'1G 501-100 I3'T'U --___ ROW DRAINS 'i:F'k1G 101-1750 IBTULAWN SPRINKLER ::F'IZIG 41750 BTU — — SEWAGE F..1ECIUR R CONDI TJONER 0-3 1W WATER SOFTENER H CONDITIONER 3-15 )}P —_- URI1:AL . .1R CONDITIONER 15-30 IIP DRINKING FOUNTAIN I R CO`IDITIONER 30-50 HI' •.1R CONDITIONER +50 IIP IJATING FANS ;VA FK)P V1'I VE COOLERS 'IAirs iES DRYER 1•NGE '1.S 1/Y;, !!ILI STE O G1.S APPI.I 1 'WE - — — '.} R ! ; !;l '!,;:H 1 - 1 001)0 '•1 .l' _ - -