HomeMy WebLinkAboutPV2021-261 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar PermitApplication®rdgw,
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Description of Work
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# Stories # Units (if Res)
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OWNER'S NAME Last ^
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Owner's Address
Owner's E-mail Address
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City (VeWiqC()_ State
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APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last F' — —
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Architect/Designees Address Architect/Designer's E-mail Address
City (_._._—_-State F_. Zip r_—.—.—. Telephoner—_
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ENGINEER'S NAME Last First F ----I Lic No.F_
Engineer's Address Engineer's E-mail Address
City State F—
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CONTRACTOR'S NAME/COMPANY iZ 3 �� y j Lic. No. �— ClassF
Contractor's Address l Contractor's E-mail Address
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City State F_ZiP �-_--_.—. .Telephone _ _
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SETBACKS REAR SETBACKS FRONT �� w PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PAN CHECK NO. S
USE ZONE DEVELOPMENT NO PAN CHECK FEES $ �'y