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1992, 06-30 Permit App: 92004458 Re-Roof
-3 50 14.A0/ LOQ ADK s as tiV/ / INFORMATION WORKSHEET PARCEL NUNBER: • STREET ADDRESS: / 0 CITY/STATE/ZIP: �,�')Q '�� Q U94 SUBDIVISION: . . BLOCB:. IAT: • ZONE: - DISTRICT: LOT AREA:- -- . F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: • . # OF DWELLINGS: .WATER DISTRICT: - OWNER: P Gj P f i4_.!LX P PHONE: 9--- ( .� Q 9 MAILING ADDRESS: CITY/STATE/ZIP: c_e7 &_.Q9__--9 93/ CONTACT: - PHONE`- - SETBACKS: - FRONT: -- . LEFT: RIGHT: ~. REAR: PERMIT USE: /N"2_, • ()(L C?' 4-10A-7- __, /l .cra **********************************************************************err***** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: .S E- - CONTRACTOR:Nap I kOcc ,Q .P _ PHONE: - v(aD MAILING ADDRESS: Ion 5-2/ , U q9 cD-,,D7) ARCHITECT/ENGINEER: PHONE:- - . - - MAILING ADDRESS: NEW: REMODEL: X- ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH I DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: