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1990, 10-02 Permit App: 90005041 Pellet Stove
INFOF1 ATI?N WORKSHEET i ' IC PARCEL NUMBER: � /d'- a0 /3 67 STREET ADDRESS: w , \ r. 1 � keJ6 _ --)Da ,. CITY/STATE/ZZP: SUBDIVISION: et BLOCK: `j LOT: Y ZONE: DISTRICT: LOT AREA: F/A: WIDTH: ' DEPTH: R/W: 2 OF BUILDI.NGS:__- € OF DWELLINGS: WATER DISTRICT:::__ _- O'wNER:j akaAl PHONE: � - ? ST13 MAILING ADDRESS: CITY/STATE/ZIP: - -- - CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT:- RIGHT: REAR: Y USE: I-�;% �� 1�_ /' --- h , f X t h f: } ! * * * * * , f f w t fi * x XX*Sx****1t xaxxA***% *********************-** *****I i Y i x BUILDING INFORMATION O:ITRACTOR LICENSE NUMBER: __-- — - CONTRAC1UR: PHONE: MAILING ADDRESS: ---- - -- - ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: I e ELL UNITS: OCCUPANT LOAD: BUILDING BGT: STORIES: BUILDING DIMENSIONS: K (WIDTH X DEPTH) SQ. FT. : REQUIPED PARKING: f HANDICAP: SEWER (Y/N) : IIYDRANT - CONTRACTOR: \'- i•`.AILING ADDRESS: * *******x**********x******************ix**x****************************** MECHANICAL I NFORMATI ON CONTRACI'OR LICA : nti e_ / CONTRACTOR: _F//4 CO e AePEN . a-Nr- • MAI LI NG AI)I)RESS: E ?S/d ��/`/ t'v[_R: -,sl'ev 'I W GG//f:"0s2 6 l � � ELECTRIC: GAS: OIL: CCAL: WJJD: SOIAR: HEAT PUMP_____ , UMP _- , ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH- PRESCRIPTIVE: POI NT: COMPONENT: SYSTEMS: MEDIAN ICAL FEES PLUMBING FEES TEM I)ESCHI PTION NUMBER OF ITEM DESCRIPTION NUMBER OF ROCESS1IZG FEE YES OR NO PROCESSING FEE YES OR NO ICT L)RK SYSTEM 'MI LETS )I)S7`J'JE/71.,:I:itT - - SINKS --- , WATER HEATER SHOWERS IITG EQUIP( 100, 000)B'1'U I3ATII TUBS AS HTG EQUIP +100,000KITCHEN SINKS :JAS PIPING - f OF UNITS --- DJ Sh[WAI'I!ERS - - - jEATFUMP 1-100 13TU --- - GARBAGE DISPOSAL - IKATPUMP 101-500 BTU CLOTHES WASHER :EATPUMP 501-1000 BTU UTILITY SINKS - ;EATPUMP 1001-1750 B'TUELECTRIC WATER HEATERS :ATPUMP +1751 BTU - FLOOR DRAIIIS -- - •:''HIG 1-100 BTU - FLOOR SINES :FP IG 101-500 I3TU BAR SINKS 'FIG 501-100 BTU --- ROOF DRAINS - EFRTG 101-1150 BTU LAWN SPRINKLER r_I''I2IG -11750 I3TU SEWAGE EJECTOR ? R CONDITIONER 0-3 IIP - -- WATER SOFTENER - ' R CONDITIONER 3-15 HP — URINAL .1 R CONDI TIONER 1.5-30 HP - DRINKING FOUNTAIN I R CONDITIONER 30-50 HP --_ • R CONDITIONER +50 IIP IJ+TI NG FANS ::VAr OPA'I'I_VE COOLERS !,OTHES DRYER - — - LNE :AS lt)S i!;t,IS'I`ED ('>S API'I<Tt ,-•p - I'' ,;Io,I I' 1 - 10(1o0