HomeMy WebLinkAboutX2021-0402 - Permit ApplicationPrint Form "Wol- etf& ComboBuil`ding $ S'olar Permit Application
(— Comm'Iesdential 000
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Description of Work
Use F—ConstTYPe V�
# Stories # Units (if Res)[_
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Valuation $
Material/LaborZjt
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OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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State®—®
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APPLICANTS NAME Last
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Applicant's Address
Applicant's E-mail Address
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State CA Zip CZ7j,4[t Telephone �J(, 56-Up5
ARCHITECT/DESIGNER'S NAME
Last First �
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OJT I `" uz— Lic. No ��
Architect/Designees Address
Architect/Designees E-mail Address
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ENGINEER'S NAME Lastr
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Engineer's Address
Engineer's E-mail Address
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State �— Zip I 92bc+$ Telephone i�-, 3o�7.1Io
CONTRACTOR'S NAME/COMPANY
Lic. No. r--_ ClassF—
Contractor's Address
Contractor's E-mail Address
City
State [— Zip �— TelephoneF_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 21 R
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N C
USE ZONE
DEVELOPMENT NO r - J PLAN CHECK FEES $