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1988, 10-12 Permit App: 88003197 Gas FurnacePARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: INFORMATION WORKSHEET SUBDIVISION: BLOCK: LOT AREA: LOT: F/A: ZONE: 4 3 DISTRICT: WIDTH: DEPTH: R/W: 6 # OF BUI INGS: # OF DWELLINGS: WATER DISTRICT: .1 -DD OWNER- /( PHONE: - Z - 3 G MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: ***********************x**********.*******************R***k******************* * CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: BUILDING INFORMATION PHONE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ_ FT.: REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: CONTRACTOR LIC#_ CONTRACTOR: 111 v 3.'1J -J__ 1,1,..= 1 LI. L'L/L\L•LCll l VLl MAILING ADDRESS: CONTRACTOR LIC#: CONTRACTOR: MECHANICAL INFORMATION MAILING ADDRESS: ELECTRIC: GAS: OIL: ENERGY CODE: WSEC: CCAL: NWEC: APPROACH: PRESCRIPTIVE: WOOD: SOLAR: HEAT PUMP UTILITY: POINT: SGC: COMPONENT: SYSTEMS: *********xx********************************************************It******* MECHANICAL FEES ITEM DESCRIPTION PROCESSING FEE DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER GAS HTG EQUIP(100,000)BTU GAS HTG EQUIP +100,000 GAS PIPING - # OF UNITS HEATPUMP 1-100 BTU HEATPUMP 101-500 BTU HEATPUMP 501-1000 BTU HEATPUMP 1001-1750 BTU HEATPUMP +1751 BTU REFRIG 1-100 BTU REFRIG 101-500 BTU REFRIG 501-100 BTU REFRIG 101-1750 BTU REFRIG +1750 BTU AIR CONDITIONER 0-3 HP AIR CONDITIONER 3-15 HP AIR CONDITIONER 15-30 HP AIR CONDITIONER 30-50 HP AIR CONDITIONER +50 HP VENTILATING FANS EVAPORATIVE COOLERS HOODS CLOTHES DRYER RANGE GAS LOG UNLISTED GAS APPLIANCE AIR HANDLER 1-10000 CFM NUMBER OF ,:'YES R NO PLUMBING FEES ITEM DESCRIPTION PROCESSING FEE TOILETS SINKS SHOWERS BATH TUBS KITCHEN SINKS DISHWASHERS GARBAGE DISPOSAL CLOTHES WASHER UTILITY SINKS ELECTRIC WA 1 ER HEATERS FLOOR DRAINS FLOOR SINKS BAR SINKS ROOF DRAINS ,I LAWN SPRINKLER S SEWAGE EJECTOR WATER SOFTENER URINAL DRINKING FOUNTAIN NUMBER OF YES OR NO