1988, 04-04 Permit App: 88000718 Remodel t
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INFORMATION WORKSHEET
PARCEL NUMBER: •
STREET ADDRESS: E. q(,/ D q Ave '
CITY/STATE/ZIP: Cj O cadn e vo vik- I q( 0h
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
n OF BUILDINGS: ( OF DWELLINGS: WATER DIS`T'RICT: ,5 c.0 Ica 0R Svt .6clit)
OWNER: tA p`teik-iA C, Q No, 1UIJ'\ 610 55 PHONE: - iv- - Sal q*
MAILING ADDRESS: e, g ID f 4? 6
CITY/STATE/ZIP: SrOlCQYe uuA( 9gc0,� .
CONTACT: o PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: Re ✓11S h b/';2-Y1^QM
****************************** ********************)t****X X***z***********XXX X
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: