1993, 08-13 Permit App: 93007022 Door APPLICATION WORKSHEET 11
i General Information
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L.IZ address gree nuruber qs ! / 1 sib 1
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Owner - L - L
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Site Information (G
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Legal Descnpt ion
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-Property size WaterDislnct Numberot: Dwellings Buildings
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LProject Information y
New I�ddition_ L Remodel I change of use
Permit Usc
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Building Information y
Dwelling unitsli
Occupantload Building height Stores
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total uare iootae Keq'd parking handicap parting SpnakMr system j trnlrcai Material
dimensions � I{
S.care foota,c breakdown Heating and insulation information (R-values)
Heat source
•am oor •iicovere• cove re. •cc � I :
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C—:1.. l Other Flat eeshng ` Vaulted ceiling Above grade wall
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1•inished basement t BelovO grade wall Moor Slab on grade
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Unfinished basement Door(u-value) Window Furnace etlicency
_ Total window area %of floor area
Garage ( l
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Contractor Information‘(
Building contractor l'tumbrng contractor t
-License number
Phone License number Phone
Mailing address Mailing address
City,state,sip City,state,tip
Hciting contractor Other/Lender i,
-License num rer
Phone License number Phone
Mailing address _ Mailing address
lily,stale.zip City.state.tip
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PItOJGCI'CON"IACI' PI-LONE