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1992, 04-22 Permit App: 92002771 Reroof 53 �� lel D(0 �1, ,2r11' ( ° xa 1fl 8 8 JOg • INFORMATION WORKSHEET t Q • PARCEL NQNBER: Slift / Q STREET ADDRESS: 7/5 C,, // 6 CITY/STATE/ZIP: 4,1 '"Ale SUBDIVISION: BLOCH:. : • • IAT: ZONE: _ DISTRICT: LOT AREA: -.' ' -F/A: WIDTH: DEPTH: R/W: • OF BUILDINGS: . # OF DWELLINGS: .WATER•DISTRICT: OWNER:' ✓/ d,/th i?t. O //Alia� __ ,:PHONE: - 9:-?4q -MAILING ADDRESS: (2 7/K • // CITY/STATE/ZIP: (_e_ / (c21 CONTACT:, ,,,c1 adi&y, i'G J� /� PHONE:- - SETBACKS: - FRONT . . LEFT: RIGHT: .-- REAR: PERMIT USE:_ A2Q, .(9_6 L2aeirn 9k *********************************************************************grate**** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: .-/4/0_ - 3 70 /,r- coNTxAcTOR:>a 4 A /iO ) es PHONE: 57319 - - l l 7()X3 9 MAILING ADDRESS: 0 ( ; 4aiLe 1(92 Qqagn ARCHITECT/ENGINEER: PHONE: - • - • - MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: ' BUILDING DIMENSIONS: S (WIDTH I DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: