HomeMy WebLinkAboutPV2022-057 - Permit Applicationw..at Worksheet for Combo Building & Solar Permit �,p plication
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI TA
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OWNER'S NAME
Owner's Address
Suite No
Use F— Const Type $o7o--r
# Stories:, # Units (if Res)[—
Valuation
Remodel SF �� Garage/New/Add F—!, Material/Labor �
Last ���4-e-f First
Owner's E-mail Address
City State I E`er- Zip 924&,D
APPLICANT'S NAME Last I ,/1/� onn��y$ First
Applicant's Address
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City FES 1-., /K�P_4e`. State
Applicant's
�E-mail Address
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Zip q_irz Telephone 9gol-3ZCe-3lCeZ
ARCHITECT/DESIGNER'S NAME Last �! First Lic. No.
ArchitecUDesigner's Address
City State (s
Architect/Designer's E-mail Address
Zip �� Telephonel
ENGINEER'S NAME Last i `✓CLS4f_L,J` First F_ Lic, No
Engineer's Address o✓ W^ P�S Engineer's E-mail Address 2
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City L / v State F (5;� Zip . _ Telephone 2g5-- -75L13
CONTRACTOR'S NAME/COMPANY �r� Lic. No. I �DZ�ILLr'7ClassLys,
Contractor's Address
City F_�4�, State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
Zip �jgi2 7... Telephone 6)In �n 35 3 3.._...
PERMIT NO.
PLAN CHECK NO. 06014022
PLAN CHECK FEES $