HomeMy WebLinkAboutXR2022-2859 - Permit Application- �-_ & Solar Permit Application
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'— NOTE: PLAN CHECK FEES DUE ATTIME 0FSUBMITTAL
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Ft4uilding F_ Grading F-_Drainage F_ Elec F_ Mech F-, Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood F_ Fire r— Liq [_ Landslide F7N/A Floor Suite No
Description of Work 1-6114-174�
Valuation $
Material/Labor
New/AddSFF—,.., _�emodelSFJ Garage/New/Add
OWNER'S NAME
Owner's Address Owner's E-mail Address
State
APPLICANT'S NAME Last
Applicant's Address Applicant's E-mail Address
zip F�
ARCH ITECT/DESI G N ER'S NAME Last /0A1V1e_A_1, First �2� AluD L i c. Nc T --,q
Architect/Designer's Address Architect/Designer's E-mail Address
C ity .... ........ ... f777Zip TelephoneF
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAMEXOMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
Cityl. State Zip Telephone F
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $