HomeMy WebLinkAboutX2021-0645 - Permit ApplicationIlorkstreet°forZombo Building & Solar Permit Appllca"tion a "
Comm'I r Residential ing Division
NOTE: PLAN CHECtyrof K FEES EES DUE AT rt Beach - TME OF SUBMITTAL -� �) o6N���
❑Building E Grading ODrainage Fj Elec ❑ Mech ❑ Plum cued cut1 curd Fill C
Project Address (Not mailing address) Flood Ej Fire Liq : ❑ Landslide ❑N/A Floor Suite No
Description of Work Use Const Type'
(Gt I rJ 16e� I y e i� lCL rL yo�
�A_ # StoriesC # Units (if Res)C
I Valuation $
New/Add S17 p yt e 1 Remodel SF f Garage/New/Add MateriaVLabor
City ieL�C�yf. State.
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Zip '�7 Telephone
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ARCHITECT/DESVGNER'S NAME Last
First—
Lic. No.
Architect0es gnees Address
ArchitectiDesigner's E-mail Address
City State
Zip Telephoned
ENGINEER'S NAME Last`C
� First C Lic. No
Engirieer's Address
Engineeirs E-mail Address
City
State
Zip
Telephone
CONTRACTOR'S NAME/COMPANY
Lk.No. �— Class
Contractor's Address;
Contractors E-mail Address '
City State
Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. i
SETBACKS LEFT SETBACKS RIGHT :
PLAN CHECK NO.
USE ZONE ,.,;i4 DEVELGP.MENT PRO'.; �' _tea PLAN CkECK FEES
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