1987, 10-16 Permit App: 07003498 MHk*****************************************************************************
INFORMATION WORKSHEET
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k PARCEL NUMBER: 0 6 S' S i 10 D 6
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k STREET ADDRESS: E_ 1 YY 6 L ;4 err/ 19 U j- *
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• CITY/STATE/ZIP_ z1 t/)/^`. / ^^ f
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k SUBDIVISION: *
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k BLOCK: LOT: ZONE: DISTRICT: *
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k LOT AREA: F/A: WIDTH: DEPTH: R/W: *
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k # OF BUILDINGS: 2-- # OF DWELLINGS: / WATER DISTRICT:
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✓ OWNER: 1<vSS'eL/ ,cogs- 1.1;75 PHONE: ,"09 -'lag- .•1G7t *
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r MAILING ADDRESS: E. 'la L i A c ,-7.-/ 11 12:-' *
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r CITY/STATE/ZIP: Of c c1 uN it/ / ujet S /y *
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r CONTACT: PHONE: - -
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r SETBACKS: - FRONT: LEFT: RIGHT: REAR: *
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PERMIT USE: *
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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:
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