HomeMy WebLinkAboutPV2019-011 - Permit ApplicationVVU�qBL- ��
Print Form Worksheet for Comboilding & Solar Permit Application 'Lee
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �'.oa��.
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Description of Work
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Material/Labor
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OWNER'S NAME
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First Lic. No. F__
Architect/Designer's Address
Architect/Designer's E-mail Address
City
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ENGINEER'S NAME
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Engineer's Address
Engineer's E-mail Address
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State Zip 5 Telephone
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CONTRACTOR'S NAME/COMPANYLic No. fJ p Class '
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Contractor's Address
C ntractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. OI
SETBACKS LEFT
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SETBACKS RIGHT PLAN CHECK NO. o1Tj�-•2A
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $