HomeMy WebLinkAboutX2021-1373 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application ��`WPoRa
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Project Address (Not mailing address) [- Flood F- Fire [- Liq [- Landslide [-N/A Floor Suite No
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Description of Work
Use Const Type
# Stories # Units (if Res)[—
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Valuation $ s C7C7�7
Material/Labor
New/Add SF Remodel SF Gara a/New/Add
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OWNER'S NAME Last First Q`K/
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last First
Applicant's Address Applicants E-mail
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ARCHITECT/DESIGNER'S NAME Last 7L�C /� pL74—L1,,5' First W/C 146>47�s No. t l7 p?
Architect/Designer's Address Architect/Designer's E-mail Address
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City �.O�lR0e_7_ � State V Zip Telephone
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ENGINEER'S NAME Last `' First F_ Lic. No.� --_ --
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY / / � �CcJ Lic. No. D15g6c/oclass
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Contractor's Address Contractor's E-mail Address
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Zip TelephonelCity at; -Poi State
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SETBACKS REAR SETBACKS FRONT PERMIT N0, X Z-r�'°-I ) �•�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. t Z I I ' Z rL I
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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