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1992, 09-25 Permit App: 92008051 Reroof
INFO3MATION WORKSHEET 4��.. PARCEL NUMBER: STREET ADDRESS: / .eep.6 /57- '741 CITY/STATE/ZIP: SUBDIVISION. BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: .WATER DISTRICT: OWNER: NEA117 /1 PHONE: - MAILING ADDRESS: /0-R06, /84-4 CITY/STATE/ZIP: 2i/4� ! (j) Q c74 ( , CONTACT: PHO :: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: 0_ : Ck BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: 5E 71/z CONTRACTOR: /,(Q ,Qk_ PHONE: .sem- S&S MAILING ADDRESS: '' a ..� 4. /�� _� .cam ARCHITECT/ENGINEER: - PHONE: - MAILING ADDRESS: NEW: REMODEL: i7- 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: