1993, 09-14 Permit App: 93008353 ReroofAPPLICATION WORKSHEET
Genera! Information
J ob address -parcel number
/-?7 Pcm
Owner
Phone
1 <"R/ iG' r.„ ` 4-2tet , 9z2 z .3
rest
Site Information
Project Information
[ Building Information
Dwelling touts
Occupant load
13tWdmg &igbt
Stones
Hua1dtng dimensions
Total squareTootage
Req'd parking
Handicap parking
Spnoklet system
Critical Material
Square footage breakdown
Ma in Moor
'ecottd floor
-1-tnts1 cd basement
Uncovered /covered deck
`Ulher
1f ;aeshed basement
`Garage
Contractor Information
Heating and insulation information (R-vatuear-t
Ilea t some
Matcewgau
cel ng
gra dc wall
Below grade wall
i-faor
Slab on grade
Door (u -value)
Window
Furnace ell iceacy
Total window area
usissasintasuesennansionsaion
9. of Hoof area
Building co Qr 424
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3S- 0) 0 � ,
pbtnb coeliac o "'
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License !c✓cr'')
_ Phone
G c j/ D D ,
License number
Phone
Mai in adds
b y A, D
/
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Mailing addresr
City,state,tip
,�f'"�'�r..e
4J4. 9 F.265
city.a zle, zip
Ideating contractor
-License
atircr/ Leader
License number
Wading address
Z`ity, slate, zip
Phone
number
-1:iniiing
'Phone
address
-City,
state, up
PROJECT CONTACT
PI{ONE