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1990, 06-21 Permit App: 90002887 Pellet Stove
1tir'ORMATION WORKSHEET '' t • A I i i 1. - PARCEL NU?�ER: ' STREET ADDRESS: -1? \\c-\ ` %. -. • z . . / It- CITY STATE/ZIP: ' 9-5\�(\ W4 �C�� SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT ARF-A: F/A: WIDTH: DEPTH: R/W: • . I OF BUILDINGS: t OF DWELLINGS: WATER DISTRICT:- - OWN 1-2R: ;mo w �, , ' 'yam*NN-- PHONE: __ -QVA - `�c- . MAILING ADDRESS: N CITY/STATE/ZIP:-----.--__ - CONTACT: -- -- - PHONE: - - SETBACKS: - FRONT: __ RIGHT:_- - I:F_JR: 1 r;I:M1T USE:---c. �x 111.30.. ` ' _t_________--_- * * * * * * * * * * * * * * *** *t***** ** ** **** * * **** * ***** ** * ** ****V*********** ** 13U I LDI NG 1NFORl:ATION 4 ;'RACTOR LICENSE NUMI3ER: _ __- C'U;:TRACIVR: PHONE: - - - t.',A 1 LI NG LI)URF.SS: -- -- --- - Ai?CiI1 TF CT/t•?•IGINEER: PHONE: _ - -_ RAI LI NG ADDRESS: 1;F;:?: REMODEL: ADDITION:_ CIIANGE OF USE: ',WELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: ' PUII.D1NG DIt'.-2 SIONS: X (WIDTH X DEPTH) SQ. FT. :_ • PEQUI PED PARKING: S HANDICAP: SEWER (Y/N) : IYYDi2ANT:_ ___ t :,.. '1-.Ci'OR I,IC# CON I TACTOR: �N • 7 MAI LING ADDRESS: �\ • -_ :::::::::*s:*::::::::************:x\*****************************::*** MECHANICAL INFORMATION CONTRACTOR LI C 1: f L &V e.. / 7`J,)� - CONTRACDR: / /4'�W er7,l�Pel-L-_• eG.cLlr rE/e _aC " ,..=,I LI NG ADDRESS: E 9N774 $Me e1S5 ' rSA4'9#e 44,'_.19-e4,-- . ._:, . t ELECTRIC: GAS: OIL: CCAL: 4WD:__ SOLAR: HEAT PUMP ENERGY CODE: W'SEC:_- - N"WEC:_ UTILITY: SGC: APPROACH> PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: MECHANICAL FEES PLUMBING FEES 'KMISI:SCRII''ri ON NUMBER OF ITEM DESCRIPTION NUMBER OF U.:}:SSING FEE YES OR NO PROCESSING FEE YES OR NO iC-l'.+:?RK 1;Y:,'1'EI - __• 1OILETS )DS'I.O'JE/I N.7ERT - -------- - SI NK$ ... •------------- = WATER I s'}-:h'1'1:F, - - ERS - --- SHOWERS �1'r IHTG EQUIP( 100, 000)BTU - ATH TUBS -- - - I .5 IITG EQUIP 4 100, 000 _ _-- Kl TY:I]I2,I SII:};S o .S PI PI NG - t OF UN ITS - DI SHWASHERS .ATI'UMI' 1-100 BTU - GAPRAGE DI Si'OSAL - - - -r,'I'PUMi' 101-500 PTU CIf.1'1'IIES WASHER - .1Ti'UMP 501-1000 icru - UTILITY SINKS - - 7,'i'i'UMI' 1001-1750 BTU - - ELECTRIC WATER HEATERS - - 1:.1'1)1uMP +1751 BTU FIADR DRAINS 'r'I G 1 -100 I371/ - _ I•-II)DR SINKS FP IG 101-500 BTU _ - PAR SI NKS - - I i I G 501-100 BTU _ - PODF DRAINS i'}<I G 101-1750 IYA.0 - I_'WN SPRINKLER FRIG -41750 BTU — S I.-•;AGE EJECTOR P CONI)]T I ONf-:R 0-3 HP _ _. WATER SOFTENER I; cti_)I:DITIONEp 3-15 HP _ __—_ URINAL R CONDI TIGNER 15-30 HP ___ DRINKING FOUNTAIN PcO':i)1 T'IONl R 30-50 IIP - — R Cc1!:UI7'IG:- i 50 lIP ---- :'I'I IJ.'1'ING FANS - - _- ,�•, A I;);'. I-I VCOOLY iP.S - - _ ri::t:S Ir;•:YER ,1 !;-• r:0 CAS APPL Ii.N'.E !. i1.i:I2 1 - IV, /C) (•i 1 .