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1992, 04-17 Permit App: 92002642 Reroof
Q/ 5( - Lkctt3 9Q-Q101-1 . ��(P 65 ) u INFORMATION WORXSHEET 2- PARCEL NUMBER: STREET ADDRESS: // () 2 14 CITY/STATE/ZIP: GjQ SUBDIVISION: BLOCK:__ IAT:_ ZONE: - DISTRICT: LOT AREA:-_'W A:___ WIDTH: DEPTH: • # OF BUILDINGS:_ . # OF DWELLINGS: .WATER DISTRICT: OWNER: (ledf)-LZ X a .ems PHONE: ~MATT.TNG ADDRESS: / ) • (/ / Q� CITY/STATE/ZIP: � v / //,),a__ ;%9a(94 4 CONTACT: PHONE:- - - SETBACKS: - FRONT: ••-• LEFT: RIGHT: - REAR: PERMIT USE: k1400 BUILDING INFORMATION CONTRACTOR LICENSE NUKBER: _S - /2 - CONTRACTOR: j 1 / _ PHONE: 5n9 - 1/7O MAILING ADDRESS: r _/ ,a ,S . ') 2 ARCHITECT/ENGINEER: PHONE: - - MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: % (WIDTH I DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: