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1992, 11-02 Permit App: 92009581 Reroof INFORMATION WORKSHEET 1/81 • tL S PARCEL NUMBER: STREET ADDRESS: /05-7g CITY/STATE/ZIP: suBDIVISIO4. BLACK: LOT: ZONE: - DISTRICT: LOT AREA: -F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: . # OFDWELLINGS: .WATER DISTRICT: - / OWNER: LII6,42AY---,X10---1,1eU-A-G--- PHONE: 5-09 - �p c�`f> - U7 7 MAILING ADDRESS: (. 0 0 .3 )776a,,,/6Le.„ 1 ��j/ -P1J_ij-.) /04 CITY/STATE/ZIP: C1 L2.lL ZA..,C:61.-L ,.E3/ Zar, l ��,g- CONTACT: PHOi - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: (2.,e_ 0 E` I ale etLf '•1 **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: j — ,-/ ,5/e_ ” 3 7 ) A) / CONTRACTOR5/1 `A41) Q S2 PHONE: ( - Vec) - MAILING ADDRESS: 7 l ) *64--a -Lp i � � C/�/ 0 ARCHITECT/ENGINEER: - PHONE: - MAILING ADDRESS: NEW: REMODEL: ✓ ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: B (WIDTH X DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: