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1992, 10-19 Permit App 92009041 Re-RoofINFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: 0102 E . gig !tissro1 SUBDIVISION:Q BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: OWNER: WATER DISTRICT: f7 it e.r 1 6-5S tLLhPHONE: so? - f24. -76 Q 3 MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: C / j f c rVl .e 6 e ,v`5 PHONE: Soct - 5QL - D 2 ' SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: 'e e ofl Q IS` R70.6cD ****************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: j, ).Z S C`/( /KZ G23 K u CONTRACTOR: W ( e lX 1\4 -p_j r 4 L MAILING ADDRESS: Li Z ) 4 pa n e1 r & 1) ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: SO? - R 2L - oz47 .SpL) q ctao PHONE: 1W- NEW: REMODEL: ADDITION: DWELL UNITS: OCCUPANT LOAD: CHANGE OF USE: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: Revised 1/88 PLUMBING INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILIVG ADDRESS: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx MECHANICAL INFORMATION CONTRACTOR LIC#: CONTRACTOR: MAILING ADDRESS: ELECTRIC: GAS: OIL: ENERGY CODE: WSEC: CCAL: WOOD: SOLAR: HEAT PUMP NWEC: UTILITY: SGC: APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx MECHANICAL FEES ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO 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 AIR HANDLER 10000 CFM PLUMBING FEES ITEM DESCRIPTION NUMBER OF PROCESSING FEE YES OR NO TOILETS SINKS SHOWERS BATH TUBS KITCHEN SINKS DISHWASHERS GARBAGE DISPOSAL CLOTHES WASHER UTILITY SINKS ELECTRIC WATER HEATERS FLOOR DRAINS FLOOR SINKS BAR SINKS ROOF DRAINS LAWN SPRINKLER SEWAGE EJECTOR WATER SOFTENER URINAL DRINKING FOUNTAIN •