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1991, 01-02 Permit App: 91000010 Wood Stove INFORMATION WORKSHEET , i % • PARCEL NUMBER: • ` ADDRESS: J tl ' Q l O Va/1:111(*tikp. - . - . . •. . . STREET , CITY STATE/ZIP: 50Q/y` .- i I : .ft. -I* • SUBDIVISION:. 3 .. • .: . :` • • BLOCK: LOT: ZONE: DISTRICT: . . • -. LOT AREA: F/A: WIDTH: DEPTH: R/W: • C OF *i3UILDINGS: € OF DWELLINGS• WATER DISTRICT: �� j� PHONE: 569 -_�! T - d?J (e OWNER )(irl _\ a,CPA uc"�' MAILING ADDRESS: _._5&YYu?..._._ • CITY/STATE/ZIP: - - CONTACT: PHONE: -______- - SETBACKS: - FRONT: LEFT: RIGHT: REAR: - w ,.� n rail t� gu y .-/Ott tgI c6 .I 5,40-0-e , •-- 1'}:1:11 I r U.�E:�9`%LGL • BUILDING 11:FOIWATION CONTRACTOR LICENSE NUMBER: - -' r C'Uli'J'12AC'JVR: _ i'IICNE: - - r MA I.1 NG ADURE1.; -- ARCHITECT/ENGINEER: PHONE: - - 1 Al LING ADDRESS: NEW: REMODEL: ADDITION: ' • CHANGE OF USE:__,,,, I) EI.L UtiI'IS: occur NT LOAD: IJUILDING IIGT: STORIES:; 'WILDING DIMENSIONS: x (WIDTH X DEPTH) SQ. FT. : - E;�UI' NIti;U PARKING:_ 1 ILAUDICAP:__,_ SEWER (Y/2i) : HYDRANT: t �O;l'1'}thC'1VR 1.1 C 1 :_ — _._ . _ _ ' •- • COMI'RACMR: ` ,r NAILING ADDRESS: //'\ : :::::*:::::::::::::::::::::::::::*s::::*s:ssx::::::::s::*:::::::::::::*: MECEAPIICAL INFORMATION . CONTRACTOR LI C I : 1 L - J - "f4' Co ego.PEN • V7F1-%W - • - COh"1'IJ►ChOR: � � • Q G _:S�'d4'�/K • `)9 _992'6 . _ 1/..k I LI NG ADDRESS: E .73�,� S /C�V�5.�--' _ , f J 1 ELECTRIC- GAS: OIL: CCAL: WOOD: X SOLAR: HEAT PUMP 7 • ENERGY CODE: W'SEC: U EC: UTILITY: SGC:__ l,i'PROACII: 1'RESCRIPTIVE: POINT:__ COMPONENT: SYSTEMS: x : : s ::::aas:: ::::: : :x:: :*:::.:: : :::s::::: : ::: : ::::::::: :::: :lt:::: : : :::::: :: MECI1ANICAL FEES PLUMBING FEES TEM• 1)E5c1211''1'1ONNUMBER OF ITEM DESCRIPTION NUMBER OF ROCESS1 NG FEE - ____ YES OR NO PROC}SSI NG FEE YES OR NO '.ICI:+:)RF: SYSTEM _ TO] LETS •')1)S1VVE/]1:.I•:}(T -- SI 1115 — i WATER I1}'J;1J:R ____ _ ,. _ SUOriERS _____ ..; 1ITG EQUI1'( 100, 000)BTUU1TJI TUBS JS IITG EQUIP 4100,000 _._ _ EITCIIEN: S11:1;5 __ __ ___ ,AS PI PING - € OF UN11 TS __________ U]SIIWA.5:l}f:RS - _'_ }:ATPUI:P 1-100 BTU ______ GARBAGE D]SPO;AL _ _— iEAJ'PUMP 101-500 BTUCI/J'1'111S �:A SIIER - r______.__ s'r:ATI'UMP 501-1000 13'1'U _ _ UT]1,1.1'Y S] NK:S _ _ .__ _— UiJ.TPU1.II' 1001-1750 IJTU _• ET.ECTRIC NATER HEATERS ____•_ 'tJ J'l'IIML' +3751 !ITU _ F1A3R HRLI NS _ ;:!-'}tI6 1-100 13'1'0 1'1/JOR SI111:S :- XI'. :FP 1 C; 101-500 ]ITI.1 _ • BAR SINKS `•'.1 T 1 C; •:1T1C; 501-] 00 BTU ___-_ ROOF 1)RAMUS _ 1:11(16 101-3750 BTU -__^ 1J.W11 SPRINF:I.F.R ::t'It 1G 41750 will s17.:4AGE EJECPOR '. I2 (7014D1T1 O:1i:R 0-3 HP % 1 L'T:R SOFTENER ' It CONDITIONER 3-15 11P ___ URINAL . ' .1n Cto:11)1Tio:1}at 15-30 11P DRINKING FOUNTAIN IR C0:11)1TJO:ICR 30-50 11P _ .1 R CONU1TIO::ER 450 HP •I.!i'1'1 1J.I I NG 1'1.11S is APOR7.'1'1 VF COOLER l '.•it is •1/J11iE S DRYER . Alit.E !AS 1/Y,; _ -- • !'11.1 ::'J 1:1) Cl; l.l'1'}.11'WE . - . - - _ A It i1 ' !:1 •!.t:1'. 1 - 10090 ''1 V. . - .