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1987, 11-12 Permit App: 87003884 Insert -1 • c ***4*44*** 444,44 * 4-.44,4*** 444'74# 4-444444,444-4-4=****44* #44r** C44*44*4 4444,4-444 *4-4,4r4 * INFORMATICN WCRK SHEET * *****4= **4444*#444444***4 ****#** ###****#*44 *****444,4#4444444444#4444#*** 4444.4-*4• * CENERAL INFORMATICN 4 * tE - elige 622-2 * l' 3— 4 * STI: EFT ACCr: ESI3I ( 1 �� � : I �� '1 _ 4 * CITY/STATE/ ZIP : )( ; 1,00_, , (^ � � n * SUP Iv IS ICN. : ___ ___ __IIJ (,.P1i #5 * * * * r) L+_ CK : I. LLT :_ "- /( N.E :_ CISIPICIa : _ * � # * LOT ARrA :� �"/y�_ F /, hICTN : Illig iJtPTF :_4 _ R / t `�' r * * 4 4 CF r'LCCS : h Lt ')WELLINI � : 4 UWNEP 3Uf A F-FCNE -----IgY - q3 7* * MAIL (NG ADOPESS : I 3 ll I ZVV 6 l * * CI TY/STATE/Z 1P : --- > �.")." 00C- - 1 9(g- I — _ 4 * * * CONTACT : FHCNE : - - * * SETEACKS - FRS_ LL _ RIGH1Lf.-72A P -� _ �Q • * lik�cJd (u!eti r c i}LcC LIQ-- J I c'UET, '✓C Cil � w ��3 * PERMIT LSE :__(}Y�r ,,,,, i **4*****4* 4 # 44444444444** 44# ** ***#** • ***********#****#*#*#***444*****444"t *** 4 4 4 4** 4 4 4 4 *** 4 4 4 4 4 4 4**4 4 4 4 4 4 4 4 4 4 4 ** * ***4 4 4 4******* **** ******* *** 4 4* **** *****#* * PLUNEINC INFCRMAT ION * * CO+VTR LIC4 : / 4 4 j/ 4 * CONWRACTCR : PFCNE :____ _____ 4 4 4 * MAILING ADCFESS : * * * 44*4*444444444444444***** 444*444.**** **4**4*****4*44****** 4*4**444****** 4*44*** * MECFANCAL INFORMATION * CONTR LIC4 :-,//_ee�j',��s5- .�yivl 4 * 6(- * * CONTRACTOR :_f��--,Z3yL.>r�'����Z���_y_�-��L' P F C N E :�yy7��.�_- * * * MAILING AD CRESS :_/� /� �3 !/ ff. �_i 7_ * * 4 * ELECTRIC :_— GAS :___ CIL :___ CCAL :_ 6GOD : SCLAR :__— FEAT FUNP :_ 4 * 4 ************X *t* ** 44*********************�*- **�********** #*x **#***4 # * ***** t4 * 4* * * - . 7c/ /' G L G': Vic, q _ ** ***4, *t,4********************** ** ****.*** . 4**** ************* 4********************s MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION NUMBER CF ITEM DESCRIPTION NUMBER OF PROCESSING FEE �� YESAR NG PROCESSING FEE YES OR NC DUCTwORK SYSTEM J TOILETS wUCCSTCVE/ INSERT 4- lb SINKS GAS WATER HEATER SHOWERS GAS HIG EQUIP<10C,000>BTU BATH TUBS GAS HTG EQUIP+100 ,000 BTU KITCHEN SINKS GAS P IP ING – t: OF UNITS DISH WASHERS HEATPUNP 1-1OOM ETU ` GARBAGE 'DISPCSAL HEATPUMP 101-500r BTU CLOTHES WASHER HE AT PUMP 501- 1 , 000M BTU UTILITY SINKS HEATPUMP 1 ,001 -1750M BTU ELECTRIC WATER HEATERS HEATPUMP + 1 , 750M BTU ' FLOOR DRAINS REFRIG 1-100M BTU _ FLOCR SINKS REERIG 101-500M BTU BAR SINKS REFRIG 501- 1 , 000M BTU ROOF GRAINS REFRIG 1 , 001- 1 , 750M BTU LAWN SPRINKLER REERIG + 1 , 750M BTU SEWAGE EJEC1CR AIR CONDITIONER 0-3 HP WATER SOFTENER AIR CCNU I T ICNER 3-15 HP URNAL AIR CCNDITICNER 15-3C HP _ DRINKING FOUNTIAN AIR. CCNCITICNER 30-50 HP AIR CONDI TFCNER +50 HP VENT ILAT ING FANS EVAPORATIVE CCOLEPS HOODS CLOTFES DRYER RANGE GAS LUG --__–_— UNLISTED GAS APPLIANCE AIR H.iNDLER 1- 10000 CFM AIR HANDLER 10000+ CFM