1994, 12-22 Permit App: 94012415 ReroofAPPLICATION INFORMATION
SITE ADDRESS ;/ % 4/ �� / J') I ri/� Parcel number
f
Legal description
Zone
Inspector district
Property size
Right of way width
Water district
OWNER r D 5 4:c. o Ins
�r '
Phone
Address j
Q/
City, state S Ric cc C �c
APPLICANT / D J n c'n . a•} ( /
,?PhoneF7 i / I
Address .� . ri)� ��
/�
V e Pi' J1 (t L / 0 )i 39P
CONTACT
Phone
PERMIT USE
Building New _ Change of use_
Add Remodel
Building height
Stories
Contractor G
Dimensions
Total square footage
License n J } ¢®
Main floor
Unfinished basement
Address ! r
dp
Second floor
Finished basement
Architect/Engineer
Garage
Decks, etc.
Value
Manufactured Home
Sign
Width:
Length:
Square footage
Height
Year:
Make:
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Relocation
Fire Safety
Previous address
Fire Sprinkler Tent _
Paint booth _ Fire Alarm _ Fireworks display
VALUE
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Fuel Storage Tanks
(Circle one) Above -ground Underground
Swimming Pool
Contents
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip