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HomeMy WebLinkAboutX2017-2873 - Permit Applicationng 8� solar Permit Application print Form , .,! Worksheet for Combo Bort Beach - Building Division X201-7.2813 City of , 11 Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL A9q�-;201'1 d OBI = r comm,l Mech Plum cued cut Drainage Elec `/ / F -N/A Floor Grading r �CL;q r Landslid! Building r mddress Flood r Firer / Address 2 Ne '10.0r o Garage/New/Add �— emodel SF Z'7 First �%SFtrn ` " OWNER'SNAME Last Owners Address +�d State City �tl %NT'S NAME Last �Pplij Ant's Address City ARCHITECT/DESIGNER'S NAME y1 State Last I �rtM Owner's E-mail Address se [� Const Type Stories # Units Of �°I©Neon Zip L Applicant's E-mail 'A`drdidgesrs� Telephone Zip. First I✓1•0_ Lic. No. ZZY/ ArchiteotlDesigner's E-mail Address �,tt�r. �1�1�>�2•�OAM A q Telephone t� `'' `•� `Z2 Zip .il1i1 ArchitectlDesigner's Address State City �L- —_ --i '' ' Last ENGINEER'S NAME Engineer's Address 111\� State Lic. No.I(, 0*15I1d First (�iG "? EngineersE-mail Address �� �� 'lf\ 0,51 b �Zr7Zj� Telepho a 14 l• 1710 Zip ' city � Lic. No. 1 0SB c2 class ANY o�� y� L CONTRACTOR'S NAME/COM" B �� Contractor's E-mail Address Contractor'sApdd/ress eo � q Ji-'?� i/G �/.LD i� /f' ✓ Telephone `7/ y %72 Zip ��G 7 p � l7 .. State City C©�� r7 PERMIT NO. SETBACKS FRONT —� PLAN CHECK NO. -r SETBACKS REAR —� SETBACKS RIGHT PLAN CHECK FEES $ SETBACKS LEFT �— nFVELOPMENT NO