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1989, 01-04 Permit App: 89000011 Wood Stove INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: S I I3 K.O4c.;\ 'e-0 CITY/STATE/ZIP: V L t w'"- q 1037 SUBDIVISION: IBLOCK: LOT: ZONE: DISTRICT: ILOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: 40? ‘5. J 'riff7 "J PHONE: S25 - 92-1-- 27 MAILING ADDRESS: S }"n'l e -- CITY/STATE/ZIP: i CONTACT: PHONE: - - \ SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: _ (.0069 E'"}DUL- its***************************s************************************************ _ _. BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: _.. CONTRACTOR: PHONE: - - MAILING ADDRESS: 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: Revised 1/88