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Description of Work
Use F_ConstType F
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# Stories # Units (if Res)F_
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Valuation $
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OWNER'S NAME Last S 7-7 E✓C— First
Owner's Address Owner's E-mail Address
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City State I Zip TeleIep
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APPLICANT'S NAME Last k)fio � u/i (222 First
Applicant's Address Applicant's E-mail Address
city State F Zip Telephoner
ARCHITECT/DESIGNER'S NAME Last First —
76'�_ Lic. No. F--
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip F Telephone) —
ENGINEER'S NAME Last _ /� First Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State Zip Telephoner
CONTRACTOR'S NAME/COMPANY %Leec� �✓tLr�Y Lic No. I/0296yy ClassFeF__q6
Contractor's Address Contractor's E-mail Address
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State Zip Tele hone
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SETBACKS REAR SETBACKS FRONT PERMITNO. 1 iU24- 0024
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. T J f , te
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $