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1988, 12-15 Permit App: 88004018 Pellet Stove 1 INFORMATION WORKSHEET PARCEL NUMBER: 235 _� ? 336y STREET ADDRESS: X' /./. 0a CITY/STATE/ZIP: SY,QI. 99D,_g7 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: , PHONE: =1 U! - 9010- 97Y MAILING ADDRESS: CITY/STATE/ZIP: 0)/ CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: ( 2Ae-) _ BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: - CONTRACTOR: PHONE: - MAILING ADDRESS: ARCHITECT/ENGINEER �PHO'NE: - - MAILING ADDRESS: NEW: REMODEL• - ADDI N: CHANGE OF USE: DWELL UNITS: AD6CUPANT LOAD: BUILD HGT: STORIES: ' BUILDING SNS: X (WIDTH X D ) SQ. FT. : ••� . REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: 1 PLU S ING INF OK`=ATION CONTRACTOR CONTRACTOR; \ i MAILING ADDRESS: ***xx*xxxx*xxxxxxx*xxxxxxxxxxxx*x*xxx*xx�x**x*xxxxx�xxx*xxxxxx*xxx***x*xxxx MECHANICAL INFORMATION CONTRACTOR LIC#: /__.. ?L C 0 G C 1 73 4 CONTRACTOR: �" !' l L C`. CN C cam/U / -17/�`, 1 /11C MAILING ADDRESS: r �iR S-2raC. (,? I-1/tire <C>=f (-CC- i ELECTRIC: GAS: OIL: CCAL: WOOD: % SOLAR: HEAT PUMP ENERGY CODE: WSEC: NWEC: UTILITY: SGC: APPROACH PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: *************************************************************************** MECHANICAL FEES PLUMBING FEES ITEM DESCRIPTION NUMBER OF ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO PROCESSING FEE YES OR NO DUCTWORK SYSTEM TOILETS WOODSTOVE/INSERT�a_elt SINKS "AS WATER HEATER SHOWERS 'S HTG EQUIP(100,000)BTU BATH TUBS .S HTG EQUIP +100,000 KITCHEN SINKS S PIPING - # OF UNITS DISHWASHERS EATPUMP 1-100 BTU GARBAGE DISPOSAL HEATPUMP 101-500 BTU CLOTHES WASHER HEATPUMP 501-1000 BTU UTILITY SINKS HEATPUMP 1001-1750 BTU ELECTRIC WATER HEATERS HEATPUMP +1751 BTU FLOOR DRAINS REFRIG 1-100 BTU FLOOR SINKS REFRIG 101-500 BTU BAR SINKS REFRIG 501-100 BTU ROOF DRAINS REFRIG 101-1750 BTU LAWN SPRINKLER REFRIG +1750 BTU SEWAGE EJECTOR AIR CONDITIONER 0-3 HP WATER SOFTENER AIR CONDITIONER 3-15 HP URINAL AIR CONDITIONER 15-30 HP DRINKING FOUNTAIN AIR CONDITIONER 30-50 HP AIR CONDITIONER +50 HP VENTILATING FANS EVAPORATIVE COOLERS SODS OTHES DRYER ICE :S LOG NLISTED GAS APPLIANCE IR HANDLER 1-10000 CFM