HomeMy WebLinkAboutPV2019-121 - Permit Application (2)Print Form .; Work*m t for Combo Building & Solar Permit Application
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Description of Work
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Applicant's Address
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ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designer's Address \ Architect/Designer's E-mail Address
City State �� Zip. Telephone
ENGINEER'S NAME Last First F Lic. No. L' -1 j
�Engineer's Address i 1l
City ; (. Q State
Engineer's E-mail Address
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CONTRACTOR'SNAME/COMPANY pr' kf / Lic. No. ,/p2 -7z_6,7 Classc;&
Contractor's Address
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Contractor's E-mail Address
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New/Add SFF
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Valuation $
Material/Labor
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OWNER'S NAME Last 3 U First
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last
Applicant's Address
933 n06Jv,((S+
City I L„p� AU,,- State r
First
Applicant's E-mail !/A�d(d,r/esus•
10A -
Zip Q2/,S? Telephone /�`?`ll � 3,t6 -3A62-...
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designer's Address \ Architect/Designer's E-mail Address
City State �� Zip. Telephone
ENGINEER'S NAME Last First F Lic. No. L' -1 j
�Engineer's Address i 1l
City ; (. Q State
Engineer's E-mail Address
Zip _ 2_& `i<p .... Telephone j ,T/OL( _..
CONTRACTOR'SNAME/COMPANY pr' kf / Lic. No. ,/p2 -7z_6,7 Classc;&
Contractor's Address
City F" State
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
Zip 14� Z? Tel2hone G ®$ ��%-�i S 2✓ �.....
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $