HomeMy WebLinkAboutX2021-2515 - Permit Applicationr,7Building
NOTE: PLAN
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N/A Floor
Suite No
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Description of Work
%( -- UseF Const Type
# Stories #UnitsifRes)'
New/Add SF�— Remodel SFV uation �.
Garage/New/Add
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OWNER'S NAME Last �)
First
Owner's Address -- _.
Owner's E-mail Address
City State �— Z`P�e .c®.✓L
Telephone
APPLICANT'S NAME Last codeFirst
Applicant's Address ----
Applicant's E-mail Address
City State F_ Zip � Telephoner
ARCHITECT/DESIGNER'S NAME
Last — First F-
ArchitectlDesigner's Address _ Lic. No.
Architect/Designer's E-mail Address
city ---Zip �— State �_ � Telephone
-
ENGINEER'S NAME Last
First Lic. No.
Engineer's Address 77777
Engineer's E-mail Address
- -
City _
State--_
Zip Telephoner
CONTRACTOR'S NAME/COMPANY '
L Lic. No. �.:���� Class
Contractor's Address �T3®oSj�
DO Contractor's E-mail Address
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City �I� r .�p✓�
State Zip
Telephone
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TBACKS REAR SETBACKS FRONT
SET KS LEFT SETBACKS RIGHT PERMIT NO.
USE ZONE
PLAN CHECK NO.
DEVELOPMENT NO Cid I
PLAN CHECK FEES $