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<br />. BUILDING INSPECTION AND RELATED SERVICES <br />CONSULTANT INFORMATION SHEET <br /> <br />1. Trade Name of Business: <br /> <br />-'f:>U\:\&.4 ~U~ ~r;t16/Je-51~ ~.AfV~ L UL <br /> <br />2. Legal Name of Business (if the Trade Name is an Assumed Name): <br /> <br />~aAN\~_ <br /> <br />3. Business Address: <br /> <br />3i-/;0() We/6'1' I~~~ v6i~l)VL~~4i@V\,~ (~Lf3( <br /> <br />Street City' State Zip <br /> <br />4. Business Telephone: (Please list all applicable phone numbers in which you can be <br />reached regarding this application): <br /> <br />_~halka-, .q.62-lu;o~.~~ ~ q52-i ~W~J;J7f3 <br /> <br />S. Name(s) of Person(s) Authorized to Represent the Business: <br /> <br />6'evel1 ~~ <br /> <br />Name <br /> <br />o-L"~~. ~~ ~ <br />Tit e . <br /> <br />Name <br /> <br />Title <br /> <br />Name <br /> <br />Title <br /> <br />- 6- <br />