HomeMy WebLinkAboutX2018-3376 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oF���"°Rm
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Comm]17, r', Resi ential X201 R- 337LOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT
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Description of Work
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Valuation $ •�^
Material/Labor 0000
New/Add SFF
Remodel SFF_ Garage/New/Add F__
OWNER'S NAME Last `-g�Llulil First �htyj , (�A K ((7 N
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
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Applicant's Address
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740 C-01` � licant's E-mail Address
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ARCHITECT/DESIGNER'S NAME LastN ' First Lic. No. FI�
Architect/Designer's Address
Architect/Designer'sE-mail Address
City F_—
State F Zip F Telephoned
ENGINEER'S NAME
Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
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State F Zip s Telephoned,
CONTRACTOR'S NAME/COMPANY y�o f tp a�T L7R0*70& Classro
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REASETBACKS
FRONT PERMIT NO. �C Lt7l'a
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SETBACKS RIGHT PLAN CHECK NO. 1-t62 11 LD l F�
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $