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1991, 01-16 Permit App: 91000171 Wood Stove • : INFORMATION WORKSHEET y I 1 ' I • PARCEL NUMBER: . ii STREET I DDRESS: r 020 q `91 ko( M k - - - it, CITY/STATE/ZIP: 0heA.u-� - - _ . :3 i. . �, .. 1 - SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: ,, . ,- . � _ . .•:• • ,'' N• lWID1'Fl: DEPTH: . R/W. LOT AREA: F/A: g OF BUILDINGS: C OF DWELLINGS- WATER DISTRICT_ ° 7 Al OWN ER::"--- . i 4 / PFIONE: 5o9 - - I MAILING ADDRE S: c S(a.,�...k__ - CITY/STATE/ZIP: CO:4'1'ACT: PHONE: - - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: 1'ERM1'l USE. futtalleit S ttaJLg - Tout, .2/00 -....0 - iidOod c-5 -0-(1-f • a. BUILDING 11:FORMATION CONTRACTOR LI CENSE;E IJUI 113ER: - ,. CONTRACTOR: _ 1'11C4E: t I I.1 NG ADD E:;.: 1 hue'IIT'ECT/ENG IUEE:R: PHONE: - - E:Al I.1 NG ADDRESS: , NE:W: 1tEI1ODEL: ADDITION: ' . MANGE OF USE: VW ELL UNITS: OCCUPANT IlD1.D: DUI LDING 1IGT: STORIES:.___— DUII.U1 NG I)l 111:11:;IONX (WI um X DE:va ) SQ. FT. : . KFnUI tr1:U MU:I11G:_ 1 IIAIIDICAP:' SEWER (Y/tt) : HYDRANT: 1,°. alade) ,fae,)7d}40.,,ie_E- Ido,-,2f-r--- 1 -e-ziorie.;.&i, --_ _. CO:1'1'RI,C'1VR 1,1C f :- - -- - MAILING ADDRESS: I*************I*******I*************\***********!*****************t**** MECSANICAL INFORMATION CONTRACTOR LIC :__�liLX066. / 7,30u CONTRACTOR F/494 CO 6/9.6761Y • e.eivr -- -.)4(6 - - • VA T.I NG 7.UD3:)'SS: L• .731.6 N&le— t i s EI.EC1'RIC: GAS: OIL: CCAL: WOOD:2( SOLAR: HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC:_ APPROACH:, PRESCRIPTIVE: POINT:__ COMPONENT: SYSTEMS: . assx**stAsa* * i **112 ! *:s ******* rs1111A * Itti• 2 : *:****** * *** ****,*.s ** ***** * ** MECHANICAL FEES PLUMBING FEES '- 'EM DESCRIPTION N• UMBER—OF__ ITEM DESCRIPTION NU[,L3EROF ' tOC ESS1 NG FEE -- --YES OR NO I'ROCESSI NG FEE YES OR NO IC1'•;:)RK :;Y:;TEM - '101 LETS _ •-)I):;Tov /]N S1•.i(T• SI UKS - WATER HF.ATE.RSHOWERS- - - - -- ..� HTG EQUI1'( 100, 000)13TU.__ _ 1;A1'11 TUBS '.S II'1G EQUIP 4-100, 000 __- . KITCHEN. :;] 1:KS __ __ - S PI PI NG - I OF 1U11ITS ,__-___ I)I 5113+'A_�IIE:RS _. :A1'I'UMP 1-100 BM ______ CAI:RAGE U]SPOSAL _ _ :.k'l'1'UMP 101-500 Ii'1'U CI/Y1'11ES WASHER - -___-__.__ :AV1'UMP 501-1000 -BTU _ _ UT]LI TTY 5] NES ___ .__ __ J.TPUML' 1001-1150 13'1'U 1:T.E:C1'RIC '.4ATER II1'J:l'ERS ! ____._ :,'1'VIIMP +3751 IITU _ l-1.03R DRAT NS _ :1-143 C; 1-100 BTU FI/DOR SI1ZI:S :1- PIG 101-500 BTU 13)+R S1UKS ' -:IT :E'I'1 G 501-] 00 BTU __ 12001-' UI2Al NS :11k16 101-1150 BTU __ 1J.WN SPRINKLER .:1.'RIG 41750 131'U SEWAGE EJE(..-POR . ! It (7ONI)1'1')U:11:R 0-3 IU' %:A1'ER SOF a:NKR ' It CONDITIONER 3-15 HP _ URINAL , . • I R CONDITIONER 15-30 HP 11RI1:FJ11G FOUNTAIN I R CD I)1T'O:lER 30-50 HP • I U CC)`1UIT/O::ER ♦ 50 IIP .NT.1 I Js1'I NG FANS AT'3it).TIVE COOLERS 'b.,I iS /Jliil:. DRYER _ -- >.Nt.E; S 1/Y.; • _ - •.1 :;'I ED Cl ; /.1,p1.1 ) `WE . _ _ _ . _ it 1, • .;1 •!.1:It 1 - I ( f'l10 (1 -11 , . - . . .