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1991, 01-07 Permit App: 91000064 StovePARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: BLOCK: IUiFOi2MA''.tlON- WORKSHEET = ... LOT: ZONE: DISTRICT: LOT AREA: F/A: WID'fll: DEPTH: R/W: +L OF BUILDINGS: € OF DWELLINGS- WATER DISTRICT: i• O:: ER : ,, R0> ith/Y.(DllwOX\ _) P3ONE: 'a (_)f — q,, — 3o 0 - • MAILING ADDRESS: (3 / - CITY/STATE/ZIP: CONTACT: SETBACKS: — FRONT:_ PERM 1T USE: LEFT: PHONE: RIGHT: REAR: 13111 LDI NG 11: FORMAT ON CY);i 3U.C:TOR 1.I CENSE 1JUfIBFR: CON'1'1 VA C: J V R : r.).1 1.1 NG MA NZ ESS : /Ski 117'ECT/I-:NGINEER: PHONE: *** *******************ssi 1'HC2iE : .1. tIA1 [.I NG ).[AUNZESS: 1U W:_ J:1-]40DEL: ADDITION CILFJJGE OF USE: DWELL UNITS: OCCUPANT IA).D: BUILDING I1GT: STORIES:_ 1SUIJ.U1 NG I)1HENS 10115: 1R1:QUI111:D 11G: X 1 HANDICAP:_ (NI DTI! x UF:i'1i") SQ. FT.: SEWER (Y/U) : I [YDRI.IIT: t CONTPACIVR 1a CI : _ •L • CONTRACTOR: N.AILI1NG ADDRESS: ••. i CONTRACTOR MCI: MECSANICAL INFORMATION CONTRACTOR: 0,0 6r ip&1 . deNTEdjW6' C • E .ys?a sMif Gut::;_S/WS'9NE" Wil:. b MAILING ADDRESS: EI.ECIRIC:_ GAS: OIL: CCAL:_ WOOD:SOIJ.R:_UF.AT PUMP__ ENERGY CODE: WSEC: ]IhEC: • UTILITY: • SGC: JJ'PROAC1I._ PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: 1'IECIIAN ICAL FEES DESC121 PTlON_ ___ NUMBER OF ROC SS1NG FEE YES OR NO '.1c;MC)RE SYSTEM •-)D:;7VVE/ 112S1 -:RT WATER BEATER —._.._ _ .. _ ..; II'rG EQUlI'(100,000)1)TU. II'1�G EQUIP +100,000 ,AS PIPING - € OF UNITS ;FATPUMP 1-100 BTU ;E TPUMP 101-500 irrii ii:ATt'UMP 501-1000 BTU ;i:ATPUMP ]001-1750 DJ'U 'i:h1•t'UMP +3751 BTU ;:F'I2)C; 1-100 BTU 1 -TIG 101-500 1ITU P:FFIG 501-300 BTU WitIG 101-1750 BTU :FRIG 41750 BTU R CONDITIONER 0-3 RP R CONDITIONER 3-15 11P AR CONDITIONER 15-30 HP IR CONDITIONER 30-50 HP AR CONDITIONER 450 HP •1.!0'IIJ.'I'IUG NABS ;:l.rO;twr1VE COOLERS 1 •.,.ii.: WIRES DRYER 1.It1;E :7.S I/Y,: "11.1 ::TET) C:7. ; !.1'I'I.r )'WE N'!:1 •!.I:R I-1(1000 'i n PLUMBING FEES ITEM DESCRIPTION i'ROCESSI/4G FEE 7vI LETS S111i-S SIIOWERS • B7.T1I 1111IS RI MIEN: SI NKS I)] S1r1+ASilEILS GARBAGE D] SI'O SAL CI/J11IFS WA SIIF:R UT] LI TY S] INKS Er.ECrRIC WATER HEATERS FLOOR, DRAINS Y solt NUMBER OF • h YES OR NO VI/YJIt S1I21'S r BAR 511)i:S 12O3F DRAl11S LAWN :1'RINELF.R SEWAGE EJECTOR WATER SOF 1tsZl- R URII;AL IDRINi'JNG FOUNTAIN