HomeMy WebLinkAboutX2020-1105 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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NOTE: PLAN CHECK FEES DUB AT TIME OF SUBMITTAL Ow",
FrV-Building ` Grading FFDrainage /Elec F-, Mech -Plum Cu Yd Cut Cu Yd Fill ;
Project Address (Not mailing address) T -J
Flood f-, Fire/ F- Landslide Floor Suite No
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Description of Work
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F-,, Const Type Fi(�
# Stories' # Units (if Res)
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New/Add SF Remodel SF
Garage/New/Add
Valuation $
Material/Labor l C&,
OWNER'S NAME Last r qj j�
First L
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Owners Address
Owners E-mail Address
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City F State
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APPLICANT'S NAME La at f 75 el-, 4: _Y_ -,i
First
Applicant's Address
Applicant's E-mail Address
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City State
Zip r,
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ARCHITECT/DESIGNER'S NAME Last L N First r
Architect/Designers Address
Architect/Designees E-mail Address
17
City F State
Zip Telephone
ENGINEER'S NAME Last F `W
First I Lic. No.17
Engineers Address
Engineers E-mail Address
City State
zip Telephone
CONTRACTOR'S NAME/COMPANY f Lic.No. 11 Class F
Contractor's Address i
Contractors E-mail Address
Li CA (A L
_C) p State
City 41. '
Z Telephone 7
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. X 6
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 02hi-S
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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