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1988, 11-22 Permit App: 88003782 Gas Line INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: / -S - CITY/STATE/ZIP: S//2 24Q//( --C)- -C) 4 S SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS,:: # OF DWELLINGS: WATER DISTRICT: OWNER: �� (// /17-e G'' PHONE: - - MAILING ADDRESS: /2- 5-2--- ,2 CITY/STATE/ZIP: 5/2e2%.er CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: ****************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: /7` ( 6 c!/j /1/r/ 1,2- 5 X ' CONTRACTOR: 67("1--e'- eel--& ! -� / PHONE: �2- 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: Qox7; coa 1 /QP